Service de Physiologie Pédiatrique-Centre du Sommeil, INSERM NeuroDiderot, Université de Paris, Hôpital Robert Debré, AP-HP, 48, boulevard Sérurier, 75019, Paris, France.
Service de Pneumopédiatrie, Centre de Ressources et de Compétences de la Mucoviscidose, Hôpital Robert Debré, AP-HP, 75019, Paris, France.
BMC Pulm Med. 2022 Jun 21;22(1):241. doi: 10.1186/s12890-022-02039-2.
Airway clearance techniques are supposed to be a necessary adjunct for the enhancement of impaired peripheral clearance in cystic fibrosis (CF). The objective was to assess the effect of one physiotherapy session (autogenic drainage: AD) on mucus clearance (sputum wet weight) and impulse oscillometry system (IOS) indices, including those obtained from extended Resistance-Inertance-Compliance (eRIC) modelling, considering the degree of bronchial congestion.
Thirty children with CF (median age: 12.7 years) in a stable condition prospectively underwent IOS measurements at baseline and after AD. They were divided in two groups: with (visual analog scale of bronchial congestion by the physiotherapist ≥ 5/10) and without (scale < 5/10) bronchial congestion. Paired-comparison of the effects of AD on airway resistance measurements was done with Wilcoxon test.
The congestion scale correlated with the wet weight of sputum production during the session (Pearson test: p < 0.0001, R = 0.66). Ten children had bronchial congestion and 20 were without congestion. In the whole group, R5-20 Hz significantly decreased after AD (P = 0.049), which was related to a decrease in the children with congestion (P = 0.025), whereas it was not significantly modified in the children without congestion (P = 0.327). The eRIC model allowed the calculation of the peripheral resistance of the respiratory system, which also decreased in the children with congestion (P = 0.037), however, not modified in the children without congestion (P = 0.390).
One session of autogenic drainage has the ability to decrease peripheral resistance obtained from IOS measurements, more specifically in children with CF with moderate to severe bronchial congestion.
ClinicalTrials.gov Identifier: NCT04094441.
气道廓清技术被认为是增强囊性纤维化（CF）外周廓清受损的必要辅助手段。目的是评估一次物理治疗（自主引流：AD）对黏液清除（痰湿重）和脉冲振荡系统（IOS）指标的影响，包括通过扩展阻力-惯性-顺应性（eRIC）建模获得的指标，并考虑到支气管充血的程度。
30 名处于稳定状态的 CF 儿童（中位年龄：12.7 岁）前瞻性地在基线和 AD 后接受 IOS 测量。他们分为两组：有（由物理治疗师评估的支气管充血视觉模拟量表≥5/10）和无（量表<5/10）支气管充血。使用 Wilcoxon 检验对 AD 对气道阻力测量的影响进行配对比较。
充血量表与治疗期间痰湿重呈正相关（Pearson 检验：p<0.0001，R=0.66）。10 名儿童有支气管充血，20 名无充血。在整个组中，AD 后 R5-20Hz 显著降低（P=0.049），这与充血儿童的降低有关（P=0.025），而在无充血儿童中没有显著改变（P=0.327）。eRIC 模型允许计算呼吸系统的外周阻力，该阻力在充血儿童中也降低（P=0.037），但在无充血儿童中没有改变（P=0.390）。
一次自主引流治疗能够降低 IOS 测量获得的外周阻力，特别是在支气管充血程度为中度至重度的 CF 儿童中。
ClinicalTrials.gov 标识符：NCT04094441。
