RT Journal Article
SR Electronic
T1 CPAP Has No Effect on Clearance, Sputum Properties, or Expectorated Volume in Cystic Fibrosis
JF Respiratory Care
FD American Association for Respiratory Care
SP 1914
OP 1919
DO 10.4187/respcare.01705
VO 57
IS 11
A1 Aquino, Evanirso Silva
A1 Shimura, Francine
A1 Santos, Adriana Silveira
A1 Goto, Danielle Miyuki
A1 Coelho, Cristiane Cenachi
A1 de Fuccio, Marcelo Bicalho
A1 Saldiva, Paulo Hilario Nascimento
A1 Lorenzi-Filho, Geraldo
A1 Rubin, Bruce K
A1 Nakagawa, Naomi Kondo
YR 2012
UL http://rc.rcjournal.com/content/57/11/1914.abstract
AB BACKGROUND: Positive expiratory pressure (PEP) is used for airway clearance in cystic fibrosis (CF) patients. Hypertonic saline (HTS) aerosol increases sputum expectoration volume and may improve respiratory secretion properties. CPAP may also be used to maintain airway patency and mobilize secretions. To evaluate if CPAP would increase the beneficial clearance effect of HTS in subjects with CF, we investigated the effects of CPAP alone and CPAP followed by HTS on sputum physical properties and expectoration volume in CF subjects. METHODS: In this crossover study, 15 CF subjects (mean age 19 y old) were randomized to interventions, 48 hours apart: directed coughs (control), CPAP at 10 cm H2O, HTS 7%, and both CPAP and HTS (CPAP+HTS). Sputum collection was performed at baseline and after interventions. Expectorated volume was determined and in vitro sputum properties were analyzed for contact angle and cough clearability. RESULTS: There were no significant differences between any treatment in arterial blood pressure, heart rate, or pulse oximetry, between the 2 time points. HTS and CPAP+HTS improved cough clearability by 50% (P = .001) and expectorated volume secretion by 530% (P = .001). However, there were no differences between control and CPAP on sputum contact angle, cough clearability, or volume of expectorated secretion. CONCLUSIONS: CPAP alone had no effect on mucus clearance, sputum properties, or expectorated volume, and did not potentiate the effect of HTS alone in CF subjects.