The intermittent intrapulmonary deflation technique for airway clearance in patients with cystic fibrosis: A randomized trial

• Published in: Respiratory medicine and research 2024-11, Vol.86, p.101094, Article 101094
• Main Authors: de Macedo, Juliana Ribeiro Fonseca Franco, Aubriot, Anne-Sophie, Reychler, Gregory, Penelle, Morgane, Gohy, Sophie, Poncin, William
• Format: Article
• Language: English
• Subjects: Adult; Airway clearance technique; Anti-Bacterial Agents - administration & dosage; Cough - etiology; Cystic fibrosis; Cystic Fibrosis - complications; Cystic Fibrosis - physiopathology; Cystic Fibrosis - therapy; Female; Humans; Intermittent intrapulmonary deflation; Male; Mucus and sputum; Respiratory Therapy - methods; Rheology; Simeox; Sputum; Young Adult
• ISSN: 2590-0412; 2590-0412
• DOI: 10.1016/j.resmer.2024.101094

Cystic fibrosis (CF) is a muco-obstructive lung disease characterized by thick sputum with abnormal rheological properties. The intermittent intrapulmonary deflation (IID) is a new instrumental airway clearance technique (ACT) that aims to decrease the sputum viscoelastic properties. This study assessed the benefits of adding the IID technique to a conventional ACT in patients with CF hospitalized for intravenous antibiotic therapy. Participants with CF accustomed to autogenic drainage (AD) as their standard ACT received, in a randomized order, a 30-min session of either AD alone or AD combined with IID (AD+IID). Sputum was collected during each ACT regimens and for a 24-hour period following both sessions. Sputum wet weight, dry weight, solids content and rheological properties were analyzed. Cough events occurring during and over 2 h post ACT were compared between both regimens. Seventeen patients with CF (aged 29 ± 11 years; FEV1%: 57.1 ± 20.1) were analysed. The sputum wet weight collected during AD alone was significantly higher than during AD+IID (8.11 ± 6.93 vs 5.40 ± 4.11 respectively, p = 0.01). The sputum rheological properties did not significantly differ between group. There were more cough episodes during AD alone compared to AD+IID (median [IQR]: 8 [5–15.5] vs 5 [3.5–11.0] respectively, p = 0.02). In participants with CF accustomed to AD, adding the IID technique in combination to AD does not confer a clear benefit on airway clearance in the short term. Clinical Trials register: NCT04157972