Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Wilrijk, Belgium.
FLUIDDA nv, Antwerp, Kontich, Belgium.
Int J Chron Obstruct Pulmon Dis. 2020 Jun 4;15:1261-1268. doi: 10.2147/COPD.S242191. eCollection 2020.
Chronic obstructive pulmonary disease (COPD) patients are prone to suffer from chronic bronchitis, which ultimately affects their quality of life and overall prognosis. Oscillating positive expiratory pressure (oPEP) devices are designed to aid in the mucus clearance by generating positive pressure pulses in the airways. The main aim of this study was to analyze the impact of a specific oPEP device - Aerobika - on top of standard of care medication in COPD patients' lung dynamics and drug deposition.
In this single-arm pilot study, patients were assessed using standard spirometry tests and functional respiratory imaging (FRI) before and after a period of 15±3 days of using the oPEP device twice daily (before their standard medication).
The utilization of the oPEP device led to a significant increase of 2.88% in specific airway volume after two weeks (1.44 (SE: 0.18) vs 1.48 (SE: 0.19); 95% CI = [0.03%,5.81%]; p=0.048). Moreover, the internal airflow distribution (IAD) was affected by the treatment: patients' changes ranged from -6.74% to 4.51%. Furthermore, IAD changes at the lower lobes were also directly correlated with variations in forced expiratory volume in one second and peak expiratory flow; conversely, IAD changes at the upper lobes were inversely correlated with these clinical parameters. Interestingly, this change in IAD was significantly correlated with changes in lobar drug deposition (=0.30, p<0.001).
Our results support that the Aerobika device utilization leads to an improved airflow, which in turn causes a shift in IAD and impacts the drug deposition patterns of the concomitant medication in patients with COPD.
慢性阻塞性肺疾病（COPD）患者易患慢性支气管炎，这最终会影响他们的生活质量和整体预后。振荡性呼气正压（oPEP）设备旨在通过在气道中产生正压脉冲来帮助清除粘液。本研究的主要目的是分析特定的 oPEP 设备-Aerobika-在 COPD 患者肺部动力学和药物沉积方面对标准护理药物的影响。
在这项单臂试验研究中，患者在使用 oPEP 设备每天两次（在他们的标准药物治疗之前）15±3 天前后使用标准肺活量测试和功能呼吸成像（FRI）进行评估。
使用 oPEP 设备两周后，特定气道容积显著增加了 2.88%（1.44（SE：0.18）比 1.48（SE：0.19）；95%CI=[0.03%，5.81%]；p=0.048）。此外，治疗还影响了内部气流分布（IAD）：患者的变化范围为-6.74%至 4.51%。此外，下叶 IAD 的变化也与用力呼气量和呼气峰流速的变化直接相关；相反，上叶 IAD 的变化与这些临床参数呈负相关。有趣的是，这种 IAD 的变化与叶状药物沉积的变化显著相关（=0.30，p<0.001）。
我们的结果支持 Aerobika 设备的使用可以改善气流，从而导致 IAD 的变化，并影响 COPD 患者伴随药物的药物沉积模式。
