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Research ArticleOriginal Research

Short-Term Effect of Autogenic Drainage on Ventilation Inhomogeneity in Adult Subjects With Stable Non-Cystic Fibrosis Bronchiectasis

William Poncin, Grégory Reychler, Noémie Leeuwerck, Nathalie Bauwens, Anne-Sophie Aubriot, Candice Nader, Giuseppe Liistro and Sophie Gohy
Respiratory Care May 2017, 62 (5) 524-531; DOI: https://doi.org/10.4187/respcare.05194
William Poncin
Department of Pneumology
Université Catholique de Louvain (UCL), Institute of Experimental and Clinical Research, Pole of Pneumology, ENT, and Dermatology, Brussels, Belgium.
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  • For correspondence: [email protected]
Grégory Reychler
Department of Pneumology
Department of Physical Medicine and Rehabilitation
Université Catholique de Louvain (UCL), Institute of Experimental and Clinical Research, Pole of Pneumology, ENT, and Dermatology, Brussels, Belgium.
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Noémie Leeuwerck
Department of Pneumology
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Nathalie Bauwens
Department of Physical Medicine and Rehabilitation
Cystic Fibrosis Unit, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Brussels, Belgium.
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Anne-Sophie Aubriot
Department of Physical Medicine and Rehabilitation
Cystic Fibrosis Unit, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Brussels, Belgium.
Université Catholique de Louvain (UCL), Institute of Experimental and Clinical Research, Pole of Pneumology, ENT, and Dermatology, Brussels, Belgium.
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Candice Nader
Department of Pneumology
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Giuseppe Liistro
Department of Pneumology
Université Catholique de Louvain (UCL), Institute of Experimental and Clinical Research, Pole of Pneumology, ENT, and Dermatology, Brussels, Belgium.
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Sophie Gohy
Department of Pneumology
Cystic Fibrosis Unit, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Brussels, Belgium.
Université Catholique de Louvain (UCL), Institute of Experimental and Clinical Research, Pole of Pneumology, ENT, and Dermatology, Brussels, Belgium.
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Abstract

BACKGROUND: Lung clearance index (LCI), a measure of ventilation inhomogeneity derived from a multiple-breath washout test, is a promising tool for assessing airway function in patients with non-cystic fibrosis bronchiectasis. However, it is unknown whether ventilation inhomogeneity could improve after successful elimination of excessive secretions within bronchiectasis. The objective of this work was to assess the short-term effects of lung secretion clearance using the autogenic drainage technique on standard lung function tests and LCI in subjects with non-cystic fibrosis bronchiectasis.

METHODS: Nitrogen-based multiple-breath washout, spirometry, and body plethysmography tests were performed 30 min before autogenic drainage in adults with stable non-cystic fibrosis bronchiectasis. The autogenic drainage session was followed by a 5-min break, after which the tests were repeated in the same order. Sputum expectorated during autogenic drainage was quantified as dry weight and correlated with change between post- and pre-measurements (Δ). Paired t test or Wilcoxon signed-rank tests were used to compare pre- and post-autogenic drainage measurement outcomes. A P value of ≤.05 was considered as statistically significant.

RESULTS: Twenty-four subjects were studied (18 females, median age [range]: 65 [21–81] y). Mean ± SD LCI significantly improved after autogenic drainage (10.88 ± 2.62 vs 10.53 ± 2.35, P = .042). However, only 20% of subjects with mucus hyperproduction during autogenic drainage had a ΔLCI that exceeded measurement variability. The percent of predicted slow vital capacity (SVC%) also slightly improved (88.7 ± 19.3% vs 90 ± 19.1%, P = .02). ΔLCI was inversely related to dry sputum weight (r = −.48, P = .02) and ΔSVC% (r = −.64, P = .001). ΔSVC% also correlated with dry sputum weight (r = 0.46, P = .02).

CONCLUSIONS: In adults with non-cystic fibrosis bronchiectasis and mucus hypersecretion, autogenic drainage improved ventilation inhomogeneity. LCI change may be the result of the maximum recruited lung volume and the amount of cleared mucus secretion. (ClinicalTrials.gov registration NCT02411981.)

  • bronchiectasis
  • chest physiotherapy
  • airway clearance technique
  • autogenic drainage
  • lung clearance index
  • lung function tests

Footnotes

  • Correspondence: William Poncin PT, MSc, Cliniques Universitaires Saint-Luc, Avenue Hippocrate 10, B-1200 Brussels, Belgium. E-mail: williamponcin8{at}gmail.com.
  • The authors have disclosed no conflicts of interest.

  • See the Related Editorial on Page 639

  • Copyright © 2017 by Daedalus Enterprises
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Respiratory Care: 62 (5)
Respiratory Care
Vol. 62, Issue 5
1 May 2017
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Short-Term Effect of Autogenic Drainage on Ventilation Inhomogeneity in Adult Subjects With Stable Non-Cystic Fibrosis Bronchiectasis
William Poncin, Grégory Reychler, Noémie Leeuwerck, Nathalie Bauwens, Anne-Sophie Aubriot, Candice Nader, Giuseppe Liistro, Sophie Gohy
Respiratory Care May 2017, 62 (5) 524-531; DOI: 10.4187/respcare.05194

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Short-Term Effect of Autogenic Drainage on Ventilation Inhomogeneity in Adult Subjects With Stable Non-Cystic Fibrosis Bronchiectasis
William Poncin, Grégory Reychler, Noémie Leeuwerck, Nathalie Bauwens, Anne-Sophie Aubriot, Candice Nader, Giuseppe Liistro, Sophie Gohy
Respiratory Care May 2017, 62 (5) 524-531; DOI: 10.4187/respcare.05194
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Keywords

  • bronchiectasis
  • chest physiotherapy
  • airway clearance technique
  • autogenic drainage
  • lung clearance index
  • lung function tests

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