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The benefits of mechanical insufflator‐exsufflator compared to autogenic drainage in adults with cystic fibrosis
Author(s) -
Helper Nir,
Kodesh Einat,
Sokol Gil,
Hakimi Ran,
Vilozni Daphna,
Efrati Ori
Publication year - 2020
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/ppul.25020
Subject(s) - medicine , cystic fibrosis , sputum , pulmonary function testing , airway , prospective cohort study , chest physiotherapy , surgery , pathology , tuberculosis
Background Autogenic drainage (AD) is used for airway clearance in individuals with cystic fibrosis (CF). The mechanical insufflator‐exsufflator (MI‐E) device is commonly used in patients with neuromuscular diseases for airway clearance by increasing inspiratory volume and expiratory flow. MI‐E use has not been studied extensively in CF patients. Objectives To examine whether there are advantages to using the MI‐E device in patients with CF. Subjects Fourteen males and eight females from the national center for CF, with an average FEV 1 of 54% were recruited Design Prospective cross‐over trial (IRB 3009‐16‐SMC). Intervention Subjects received either AD or MI‐E in a random order. Sputum was collected and weighed immediately after treatment. Subjects performed lung function tests at baseline, 20 minutes after and 1 hour after treatment; additionally, a 2‐minute walk test was performed at the end of all lung function tests. Saturation, dyspnea scores while resting and after a 2‐minute walk and subjective fatigue were recorded. Results Thirty‐six percent more sputum was collected following MI‐E than AD treatment ( P < .0001). A significant difference in saturation in response to the 2MWT was noted in both treatments significantly less desaturation was recorded after the 2MWT in the MI‐E treatment ( P < .01). Conclusions Treatment with the MI‐E was more effective for clearing sputum in CF subjects, initial evidence suggests that the MI‐E may be successfully incorporated into treatment protocols. Further studies are needed to assess the long‐term benefits of MI‐E in patients with CF.