Physiotherapy Department, Royal Prince Alfred Hospital, Sydney, Australia.
Centre for Education & Workforce Development, Sydney Local Health District, Sydney, Australia.
BMC Pulm Med. 2019 Jul 16;19(1):128. doi: 10.1186/s12890-019-0886-7.
In people with and without Cystic Fibrosis (CF), does side lying during nebulisation change: the proportion of the dose loaded in the nebuliser that is deposited in the lungs; the uniformity of deposition throughout the lungs; or the apical drug density as a percentage of the drug density in the remaining lung? Do these effects differ depending on the degree of lung disease present?
A randomised crossover trial with concealed allocation, intention-to-treat analysis and blinded assessors, involving 39 adults: 13 healthy, 13 with mild CF lung disease (FEV > 80%pred), and 13 with more advanced CF lung disease (FEV < 80%pred). In random order, 4 mL of nebulised radioaerosol was inhaled in upright sitting and in alternate right and left side lying at 2-min intervals, for 20 min.
Compared to sitting upright, lung deposition and the uniformity of deposition were not significantly altered by side lying in any of the three groups. In sitting, the density of the deposition was significantly less in the apical regions than in the rest of the lung in all participants. Side lying significantly improved apical deposition in healthy adults (MD, 13%; 95% CI, 7 to 19), and in minimal CF lung disease (MD, 4%; 95% CI, 1 to 7) but not in advanced disease (MD, 4%; 95% CI, - 2 to 9).
Alternating between right and left side lying during nebulisation significantly improves apical deposition in healthy adults and in adults with mild CF lung disease, without substantial detriment to overall deposition.
ACTRN12611000674932 (Healthy), ACTRN12611000672954 (CF) Retrospectively registered 4/7/2011.
在患有囊性纤维化（CF）和不患有 CF 的人群中，雾化治疗时侧卧是否会改变：雾化器中加载的剂量有多少沉积在肺部；肺部沉积的均匀度；或者作为肺部剩余药物密度的百分比的药物密度在肺尖部的密度？这些效果是否因存在的肺部疾病的严重程度而不同？
一项随机交叉试验，采用隐匿分组、意向治疗分析和盲法评估，涉及 39 名成年人：13 名健康人，13 名患有轻度 CF 肺部疾病（FEV>80%预测值），13 名患有更严重 CF 肺部疾病（FEV<80%预测值）。以 2 分钟为间隔，在随机顺序下，39 名参与者分别在直立坐姿和左右侧卧位各接受 4 毫升雾化放射性气溶胶吸入治疗，共 20 分钟。
与直立坐姿相比，侧卧在三组中均未显著改变肺沉积和沉积的均匀度。在坐姿时，所有参与者的肺尖部沉积密度明显低于其余肺部。侧卧在健康成年人中显著改善了肺尖部的沉积（MD，13%；95%CI，7 至 19），在轻度 CF 肺部疾病中也显著改善了沉积（MD，4%；95%CI，1 至 7），但在晚期疾病中没有改善（MD，4%；95%CI，-2 至 9）。
在雾化治疗期间左右侧卧交替可显著改善健康成年人和轻度 CF 肺部疾病成年人的肺尖部沉积，而不会对整体沉积产生实质性的不利影响。
ACTRN12611000674932（健康），ACTRN12611000672954（CF），2011 年 7 月 4 日回顾性注册。
