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Comparison of flutter device and chest physical therapy in the treatment of cystic fibrosis pulmonary exacerbation
Author(s) -
Gondor Magdalen,
Nixon Patricia A.,
Mutich Rebecca,
Rebovich Paul,
Orenstein David M.
Publication year - 1999
Publication title -
pediatric pulmonology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.866
H-Index - 106
eISSN - 1099-0496
pISSN - 8755-6863
DOI - 10.1002/(sici)1099-0496(199910)28:4<255::aid-ppul4>3.0.co;2-k
Subject(s) - medicine , vital capacity , pulmonary function testing , exacerbation , cystic fibrosis , cardiology , chest physiotherapy , anesthesia , lung , lung function , diffusing capacity
Chest physiotherapy (CPT) is recommended for the clearance of bronchial secretions in the management of patients with cystic fibrosis (CF). The Flutter® valve (Scandipharm, Birmingham, AL) has been introduced as an alternative method to CPT for airway mucus clearance. The objective of this study was to compare the short‐term effects of CPT and the Flutter® valve on pulmonary function and exercise tolerance in patients with cystic fibrosis. Twenty‐three patients, 5 to 21 years of age, were randomized to receive one of two interventions: CPT or the Flutter® valve, upon admission to the hospital for a 2‐week treatment of pulmonary exacerbation. Pulmonary function testing (PFTs) and the 6‐min walk test were performed on admission, day 7, and day 14 of hospitalization. Data analysis indicated no significant differences between the two groups on admission. Both groups showed improvement in pulmonary function test results, but the Flutter® group had a higher mean forced vital capacity (FVC) and forced expiratory volume in 1 sec (FEV 1 ) compared to the CPT group after 1 week of intervention. Both groups continued to improve during the 2‐week intervention, with no significant difference in FVC or FEV 1 between groups by the end of 2 weeks. Mean forced expiratory flow rate between 25–75% of vital capacity (FEF 25–75 ), 6‐min walk distance, and resting arterial oxyhemoglobin saturation (SaO 2 ) showed little change by day 7, but improved significantly ( P < 0.05) by day 14 of hospitalization in both groups, with no significant difference between groups. This study demonstrated that patients using the Flutter® device had better pulmonary function after 1 week of therapy and similar improvement in pulmonary function and exercise tolerance compared to CPT after 2 weeks of therapy, suggesting that Flutter® valve therapy is an acceptable alternative to standard CPT during in‐hospital care of patients with CF. Pediatr Pulmonol. 1999;28:255–260. © 1999 Wiley‐Liss, Inc.