Chest
Volume 125, Issue 4, April 2004, Pages 1507-1511
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Preliminary Report
Pulmonary Function and Sputum Production in Patients With Cystic Fibrosis: A Pilot Study Comparing the PercussiveTech HF Device and Standard Chest Physiotherapy

https://doi.org/10.1378/chest.125.4.1507Get rights and content

Study objective

To compare the PercussiveTech HF (PTHF) device (Vortran Medical Technology 1; Sacramento, CA) to standard manual chest physiotherapy (CPT) with respect to acute changes in pulmonary function, sputum production, and pulse oximetry in patients with cystic fibrosis (CF).

Design

Randomized crossover.

Setting

University-affiliated, community-based CF center.

Participants

Ten clinically stable patients with CF (age range, 10 to 21 years; mean age, 15.3 years) with Shwachman scores from 55 to 95 (mean 75).

Interventions

Two treatment regimens were used: 2.5 mg of albuterol delivered via updraft nebulizer followed by standard CPT, and 2.5 mg of albuterol delivered via the PTHF device without CPT.

Results

Outcome measures included pulmonary function test (PFT) results 4 h after treatment and quantitative sputum production during the 4 h after treatment. Pulse oximetry was performed during treatment. A patient satisfaction questionnaire was administered at the end of the study. No PFT parameters were significantly changed 4 h after CPT or PTHF, although there was a trend to decreasing residual volume after both treatments. There was a trend for more sputum production after PTHF compared to CPT, but this did not reach statistical significance. There were no episodes of hemoglobin-oxygen desaturation during or after either treatment. One patient had minor hemoptysis after CPT. No adverse effects occurred after PTHF. Eight patients found the PTHF device easy to use, and six patients would prefer the PTHF device to CPT.

Conclusions

The PTHF device appears to be a safe and effective method of airway clearance in CF patients in this small pilot study.

Section snippets

Materials and Methods

The study was approved by the Human Use Committee of Bronson Methodist Hospital. Informed consent was obtained from all participants and the parents/guardians of those patients < 18 years old.

Ten participants recruited from the Cystic Fibrosis Center at Michigan State University/Kalamazoo Center for Medical Studies had a diagnosis of CF confirmed by clinical history, physical examination, and sweat chloride level ≥ 60 mEq/L and/or genetic testing. Patients were included if they were clinically

Results

Nine participants completed the study. Participant demographics are shown in Table 1. One patient was excluded after having minor hemoptysis following CPT. All participants had mild-to-moderate disease severity. All tolerated both treatments with no significant oxyhemoglobin desaturation (data not shown). Mean pulmonary function and wet and dry sputum weight results are shown in Table 2. No PFT parameters were significantly changed at 4 h after CPT or PTHF, although there was a trend to

Discussion

This is the first clinical study of the PTHF device compared to standard CPT. Although a small, single-intervention pilot study, we feel it demonstrates the short-term safety and efficacy of the PTHF device. We have previously studied the Flutter device and the IPV in patients with CF.345 These airway clearance devices utilize oscillating positive pressure delivered to the airway to enhance clearance of airway secretions. In two short-term studies, we found no difference in sputum production

References (12)

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Presented at the Thirteenth Annual North American Cystic Fibrosis Conference, Seattle, Washington, October, 1999.

Supported by a research grant from Vortran Medical Technology 1, Sacramento, CA.

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