Vibralung 声学叩击仪对囊性纤维化患者肺功能和排痰的影响。
Influence of the Vibralung Acoustical Percussor on pulmonary function and sputum expectoration in individuals with cystic fibrosis.
机构信息
Department of Cardiovascular Diseases, Mayo Clinic, 13400 East Shea Boulevard, Scottsdale, AZ 85259, USA Department of Pharmacy Practice and Science, University of Arizona, Tucson, AZ, USA.
Department of Anesthesiology, Mayo Clinic, Rochester, MN, USA Department of Pharmacy Practice and Science, University of Arizona, Tucson, AZ, USA.
出版信息
Ther Adv Respir Dis. 2018 Jan-Dec;12:1753466618770997. doi: 10.1177/1753466618770997.
BACKGROUND
The Vibralung Acoustical Percussor is a new airway clearance therapy (ACT) utilizing intrapulmonary sound waves in addition to positive expiratory pressure (PEP). We evaluated the safety of the Vibralung and collected preliminary data on its ability to mediate sputum expectoration in individuals with cystic fibrosis (CF).
METHODS
Over two separate studies, 10 and 11 mild to moderate CF patients were recruited for study I and II, respectively. Study I: Vibralung was used for 20 min with either no sound (NS: PEP only) or sound (S: PEP and sound) on randomized visits. Pulmonary function, diffusion capacity of the lungs for carbon monoxide and nitric oxide (DL/DL), symptoms, and peripheral oxygen saturation (SpO) were measured at baseline and at 1 and 4 h post treatment. Expectorated sputum was collected over 4 h post treatment. Study II: over 5 days of in-hospital therapy, the Vibralung or vibratory vest therapy (Vest) were used for two therapy sessions per day, with sputum collected for 20 min following each therapy and pulmonary function accessed pre and post each 5-day period (days 1-5 or 7-11) in a randomized crossover design.
RESULTS
Vibralung usage resulted in no change from baseline to 4 h post in pulmonary function, SpO or symptoms ( p > 0.05). At 4 h post therapy, the DL- and DL-derived measure of alveolar-capillary unit function (DM/ V) showed improvement (DM/ V = 12.5 ± 5.5 versus 7.3 ± 18.8% change, S versus NS) with no difference between S and NS ( p = 0.74). Sputum expectoration was similar between S and NS conditions (wet sputum = 10.5 ± 4.6 versus 9.9 ± 3.2 g, S versus NS, p = 0.25). There were no differences in the improvement in pulmonary function between Vibralung and Vest during either 5-day period during the hospital stay.
CONCLUSIONS
Vibralung was well tolerated and caused no detrimental changes in pulmonary function metrics. The Vibralung appears to be a safe ACT in individuals with CF.
背景
Vibralung 声学叩击仪是一种新型气道清除治疗（ACT）方法，它利用肺内声波，外加呼气正压（PEP）。我们评估了 Vibralung 的安全性，并收集了其在囊性纤维化（CF）患者中促进排痰的初步数据。
方法
在两项独立的研究中，分别招募了 10 名和 11 名轻度至中度 CF 患者参加研究 I 和 II。研究 I：在随机访问中，Vibralung 分别使用无音（NS：仅 PEP）或有声（S：PEP 和声音）治疗 20 分钟。在治疗前、治疗后 1 小时和 4 小时测量肺功能、一氧化碳和一氧化氮的肺扩散能力（DL/DL）、症状和外周血氧饱和度（SpO）。在治疗后 4 小时内收集咳出的痰。研究 II：在住院治疗的 5 天内，每天使用 Vibralung 或振动背心治疗（Vest）两次，每次治疗后 20 分钟收集痰，并在每天（第 1-5 天或第 7-11 天）的随机交叉设计中，在每个 5 天期前后测量肺功能。
结果
Vibralung 使用后，肺功能、SpO 或症状在治疗后 4 小时内均未发生变化（p>0.05）。治疗后 4 小时，DL 和 DL 衍生的肺泡毛细血管单位功能测定值（DM/ V）改善（DM/ V=12.5±5.5 与 7.3±18.8%变化，S 与 NS），但 S 与 NS 之间无差异（p=0.74）。S 与 NS 条件下的痰液排出量相似（湿痰=10.5±4.6 与 9.9±3.2g，S 与 NS，p=0.25）。在住院期间的两个 5 天期间，Vibralung 与 Vest 对肺功能的改善均无差异。
结论
Vibralung 耐受性良好，不会对肺功能指标造成不利影响。Vibralung 似乎是 CF 患者的一种安全的 ACT。
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