Rodriguez Hortal Maria Cecilia, Nygren-Bonnier Malin, Hjelte Lena
Department of Physical Therapy, Karolinska University Hospital, Huddinge, Sweden.
Department of Clinical Science, Intervention and Technology, CLINTEC, Karolinska Institutet, Stockholm, Sweden.
Physiother Res Int. 2017 Jul;22(3). doi: 10.1002/pri.1667. Epub 2016 Feb 29.
For patients with cystic fibrosis, chest physiotherapy is crucial for evacuating airway secretions. Because chest physiotherapy increases energy expenditure, fatigue and dyspnoea, non-invasive ventilation (NIV) could be beneficial for severely ill patients during airway clearance. The aim of the study is to evaluate and compare the effects between NIV and positive expiratory pressure (PEP) on airway clearance.
Prospective, randomized trial compares PEP to NIV. Thirty-two subjects, mean age 31 years, mean forced expiratory volume in 1 second 47% (±14) and mean forced vital capacity 69% (±13), completed a 3-month randomized trial comparing NIV with standard PEP treatment as airway clearance technique. Lung functions testing, 6-minute walk test, blood gases, sputum culture and inflammatory parameters were measured before and after the treatment period.
There was a significant reduction in lung clearance index (LCI) following NIV compared with PEP (p = 0.01). LCI is performed within the lung function testing.
Non-invasive ventilation was shown to be a good alternative to PEP in chest physiotherapy for patients with cystic fibrosis who are severely ill.
对于囊性纤维化患者，胸部物理治疗对于排出气道分泌物至关重要。由于胸部物理治疗会增加能量消耗、疲劳和呼吸困难，无创通气（NIV）可能对重症患者在气道清理期间有益。本研究的目的是评估和比较NIV与呼气末正压（PEP）对气道清理的效果。
前瞻性随机试验将PEP与NIV进行比较。32名受试者，平均年龄31岁，一秒用力呼气量平均为47%（±14），用力肺活量平均为69%（±13），完成了一项为期3个月的随机试验，比较NIV与标准PEP治疗作为气道清理技术的效果。在治疗期前后测量肺功能测试、6分钟步行试验、血气、痰培养和炎症参数。
与PEP相比，NIV后肺清除指数（LCI）显著降低（p = 0.01）。LCI在肺功能测试中进行。
对于重症囊性纤维化患者，无创通气在胸部物理治疗中被证明是PEP的良好替代方法。
