Effect of airway clearance therapies on mucociliary clearance in adults with cystic fibrosis: A randomized controlled trial.

<h4>Background</h4>Cystic fibrosis (CF) is an inherited disorder causing impaired mucociliary clearance within the respiratory tract, and is associated with bronchiectasis, chronic respiratory infections, and early death. Airway clearance therapies have long been a cornerstone of managem...

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Main Authors: Aaron Trimble, Kirby Zeman, Jihong Wu, Agathe Ceppe, William Bennett, Scott Donaldson
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2022-01-01
Series:PLoS ONE
Online Access:https://doi.org/10.1371/journal.pone.0268622
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author Aaron Trimble
Kirby Zeman
Jihong Wu
Agathe Ceppe
William Bennett
Scott Donaldson
author_facet Aaron Trimble
Kirby Zeman
Jihong Wu
Agathe Ceppe
William Bennett
Scott Donaldson
author_sort Aaron Trimble
collection DOAJ
description <h4>Background</h4>Cystic fibrosis (CF) is an inherited disorder causing impaired mucociliary clearance within the respiratory tract, and is associated with bronchiectasis, chronic respiratory infections, and early death. Airway clearance therapies have long been a cornerstone of management of individuals with CF, although evidence supporting their use is lacking. We designed a randomized controlled trial to quantitatively compare the effects of different forms of airway clearance on mucociliary clearance.<h4>Methods</h4>Three different physiotherapy methods to augment cough-clearance were studied in addition to cough-clearance alone: high-frequency chest-wall oscillating vest, oscillatory positive expiratory pressure, and whole-body vibration. We used gamma scintigraphy after inhalation of radiolabeled particles to quantify mucus clearance before, during, and after physiotherapy. As secondary endpoints, we measured concentrations of small molecules in exhaled breath that may impact mucus clearance.<h4>Results</h4>Ten subjects were enrolled and completed study procedures. No differences were identified between any method of airway clearance, including cough clearance alone. We did identify changes in certain small molecule concentrations in exhaled breath following airway clearance.<h4>Conclusions</h4>Due to the limitations of this study, we do not believe the negative results suggest a change in clinical practice with regard to airway clearance. Findings pertaining to small molecules in exhaled breath may serve as future opportunities for study.
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spelling doaj.art-6e63fdc6b2d143f4b54c5154dbdf4f832022-12-22T01:53:05ZengPublic Library of Science (PLoS)PLoS ONE1932-62032022-01-01175e026862210.1371/journal.pone.0268622Effect of airway clearance therapies on mucociliary clearance in adults with cystic fibrosis: A randomized controlled trial.Aaron TrimbleKirby ZemanJihong WuAgathe CeppeWilliam BennettScott Donaldson<h4>Background</h4>Cystic fibrosis (CF) is an inherited disorder causing impaired mucociliary clearance within the respiratory tract, and is associated with bronchiectasis, chronic respiratory infections, and early death. Airway clearance therapies have long been a cornerstone of management of individuals with CF, although evidence supporting their use is lacking. We designed a randomized controlled trial to quantitatively compare the effects of different forms of airway clearance on mucociliary clearance.<h4>Methods</h4>Three different physiotherapy methods to augment cough-clearance were studied in addition to cough-clearance alone: high-frequency chest-wall oscillating vest, oscillatory positive expiratory pressure, and whole-body vibration. We used gamma scintigraphy after inhalation of radiolabeled particles to quantify mucus clearance before, during, and after physiotherapy. As secondary endpoints, we measured concentrations of small molecules in exhaled breath that may impact mucus clearance.<h4>Results</h4>Ten subjects were enrolled and completed study procedures. No differences were identified between any method of airway clearance, including cough clearance alone. We did identify changes in certain small molecule concentrations in exhaled breath following airway clearance.<h4>Conclusions</h4>Due to the limitations of this study, we do not believe the negative results suggest a change in clinical practice with regard to airway clearance. Findings pertaining to small molecules in exhaled breath may serve as future opportunities for study.https://doi.org/10.1371/journal.pone.0268622
spellingShingle Aaron Trimble
Kirby Zeman
Jihong Wu
Agathe Ceppe
William Bennett
Scott Donaldson
Effect of airway clearance therapies on mucociliary clearance in adults with cystic fibrosis: A randomized controlled trial.
PLoS ONE
title Effect of airway clearance therapies on mucociliary clearance in adults with cystic fibrosis: A randomized controlled trial.
title_full Effect of airway clearance therapies on mucociliary clearance in adults with cystic fibrosis: A randomized controlled trial.
title_fullStr Effect of airway clearance therapies on mucociliary clearance in adults with cystic fibrosis: A randomized controlled trial.
title_full_unstemmed Effect of airway clearance therapies on mucociliary clearance in adults with cystic fibrosis: A randomized controlled trial.
title_short Effect of airway clearance therapies on mucociliary clearance in adults with cystic fibrosis: A randomized controlled trial.
title_sort effect of airway clearance therapies on mucociliary clearance in adults with cystic fibrosis a randomized controlled trial
url https://doi.org/10.1371/journal.pone.0268622
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