Side lying during nebulisation can significantly improve apical deposition in healthy adults and adults with mild cystic fibrosis lung disease: a randomised crossover trial
Abstract Background In people with and without Cystic Fibrosis (CF), does side lying during nebulisation change: the proportion of the dose loaded in the nebuliser that is deposited in the lungs; the uniformity of deposition throughout the lungs; or the apical drug density as a percentage of the dru...
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| Format: | Article |
| Language: | English |
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BMC
2019-07-01
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| Series: | BMC Pulmonary Medicine |
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| Online Access: | http://link.springer.com/article/10.1186/s12890-019-0886-7 |
| _version_ | 1818528284498984960 |
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| author | Ruth L. Dentice Mark R. Elkins Jordan Verschuer Stefan Eberl Genevieve Dwyer Peter T. P. Bye |
| author_facet | Ruth L. Dentice Mark R. Elkins Jordan Verschuer Stefan Eberl Genevieve Dwyer Peter T. P. Bye |
| author_sort | Ruth L. Dentice |
| collection | DOAJ |
| description | Abstract Background In people with and without Cystic Fibrosis (CF), does side lying during nebulisation change: the proportion of the dose loaded in the nebuliser that is deposited in the lungs; the uniformity of deposition throughout the lungs; or the apical drug density as a percentage of the drug density in the remaining lung? Do these effects differ depending on the degree of lung disease present? Methods A randomised crossover trial with concealed allocation, intention-to-treat analysis and blinded assessors, involving 39 adults: 13 healthy, 13 with mild CF lung disease (FEV1 > 80%pred), and 13 with more advanced CF lung disease (FEV1 < 80%pred). In random order, 4 mL of nebulised radioaerosol was inhaled in upright sitting and in alternate right and left side lying at 2-min intervals, for 20 min. Results Compared to sitting upright, lung deposition and the uniformity of deposition were not significantly altered by side lying in any of the three groups. In sitting, the density of the deposition was significantly less in the apical regions than in the rest of the lung in all participants. Side lying significantly improved apical deposition in healthy adults (MD, 13%; 95% CI, 7 to 19), and in minimal CF lung disease (MD, 4%; 95% CI, 1 to 7) but not in advanced disease (MD, 4%; 95% CI, − 2 to 9). Conclusion Alternating between right and left side lying during nebulisation significantly improves apical deposition in healthy adults and in adults with mild CF lung disease, without substantial detriment to overall deposition. Trial registration ACTRN12611000674932 (Healthy), ACTRN12611000672954 (CF) Retrospectively registered 4/7/2011. |
| first_indexed | 2024-12-11T06:47:47Z |
| format | Article |
| id | doaj.art-195f7435852244b58ccc12172d998348 |
| institution | Directory Open Access Journal |
| issn | 1471-2466 |
| language | English |
| last_indexed | 2024-12-11T06:47:47Z |
| publishDate | 2019-07-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Pulmonary Medicine |
| spelling | doaj.art-195f7435852244b58ccc12172d9983482022-12-22T01:17:00ZengBMCBMC Pulmonary Medicine1471-24662019-07-011911710.1186/s12890-019-0886-7Side lying during nebulisation can significantly improve apical deposition in healthy adults and adults with mild cystic fibrosis lung disease: a randomised crossover trialRuth L. Dentice0Mark R. Elkins1Jordan Verschuer2Stefan Eberl3Genevieve Dwyer4Peter T. P. Bye5Physiotherapy Department, Royal Prince Alfred HospitalCentre for Education & Workforce Development, Sydney Local Health DistrictDepartment of Molecular Imaging, Royal Prince Alfred HospitalDepartment of Molecular Imaging, Royal Prince Alfred HospitalPhysiotherapy Program, Western Sydney UniversitySydney Medical School, University of SydneyAbstract Background In people with and without Cystic Fibrosis (CF), does side lying during nebulisation change: the proportion of the dose loaded in the nebuliser that is deposited in the lungs; the uniformity of deposition throughout the lungs; or the apical drug density as a percentage of the drug density in the remaining lung? Do these effects differ depending on the degree of lung disease present? Methods A randomised crossover trial with concealed allocation, intention-to-treat analysis and blinded assessors, involving 39 adults: 13 healthy, 13 with mild CF lung disease (FEV1 > 80%pred), and 13 with more advanced CF lung disease (FEV1 < 80%pred). In random order, 4 mL of nebulised radioaerosol was inhaled in upright sitting and in alternate right and left side lying at 2-min intervals, for 20 min. Results Compared to sitting upright, lung deposition and the uniformity of deposition were not significantly altered by side lying in any of the three groups. In sitting, the density of the deposition was significantly less in the apical regions than in the rest of the lung in all participants. Side lying significantly improved apical deposition in healthy adults (MD, 13%; 95% CI, 7 to 19), and in minimal CF lung disease (MD, 4%; 95% CI, 1 to 7) but not in advanced disease (MD, 4%; 95% CI, − 2 to 9). Conclusion Alternating between right and left side lying during nebulisation significantly improves apical deposition in healthy adults and in adults with mild CF lung disease, without substantial detriment to overall deposition. Trial registration ACTRN12611000674932 (Healthy), ACTRN12611000672954 (CF) Retrospectively registered 4/7/2011.http://link.springer.com/article/10.1186/s12890-019-0886-7Cystic fibrosisBody positionLung depositionPhysical therapy |
| spellingShingle | Ruth L. Dentice Mark R. Elkins Jordan Verschuer Stefan Eberl Genevieve Dwyer Peter T. P. Bye Side lying during nebulisation can significantly improve apical deposition in healthy adults and adults with mild cystic fibrosis lung disease: a randomised crossover trial BMC Pulmonary Medicine Cystic fibrosis Body position Lung deposition Physical therapy |
| title | Side lying during nebulisation can significantly improve apical deposition in healthy adults and adults with mild cystic fibrosis lung disease: a randomised crossover trial |
| title_full | Side lying during nebulisation can significantly improve apical deposition in healthy adults and adults with mild cystic fibrosis lung disease: a randomised crossover trial |
| title_fullStr | Side lying during nebulisation can significantly improve apical deposition in healthy adults and adults with mild cystic fibrosis lung disease: a randomised crossover trial |
| title_full_unstemmed | Side lying during nebulisation can significantly improve apical deposition in healthy adults and adults with mild cystic fibrosis lung disease: a randomised crossover trial |
| title_short | Side lying during nebulisation can significantly improve apical deposition in healthy adults and adults with mild cystic fibrosis lung disease: a randomised crossover trial |
| title_sort | side lying during nebulisation can significantly improve apical deposition in healthy adults and adults with mild cystic fibrosis lung disease a randomised crossover trial |
| topic | Cystic fibrosis Body position Lung deposition Physical therapy |
| url | http://link.springer.com/article/10.1186/s12890-019-0886-7 |
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