Abstract
Background: Streamlining the timing of treatments in Cystic Fibrosis (CF) is important to optimise adherence whilst ensuring efficacy. The optimal timing of treatment with hypertonic saline (HTS) and airway clearance techniques (ACT) is unknown.
Objectives: This study hypothesised that HTS before ACT would be more effective than HTS during ACT as measured by lung clearance index (LCI).
Methods: Adults with CF providing written informed consent were randomised to a crossover trial of HTS before ACT or HTS during ACT on consecutive days. ACT treatment consisted of Acapella® Duet. Patients completed LCI and spirometry at baseline and 90 mins post treatment. Mean difference (MD) and 95% confidence intervals (95% CI) were reported.
Results: 13 subjects completed the study (mean [SD] age 33 [12] years, FEV1% predicted 51% [22], LCI (no. turnovers) 14 [4]). Comparing the two treatments (HTS before ACT vs HTS during ACT), the change from baseline to 90 mins post treatment in LCI (MD [95% CI] -0.02 [-0.63 to 0.59]) and FEV1% predicted (MD [95% CI] -0.25 [-2.50 to 1.99]) was not significant. There was no difference in sputum weight (MD [95% CI] -3.0 [-14.9 to 8.9]), patient perceived ease of clearance (MD [95% CI] 0.4 [-0.6 to 1.3) or satisfaction (MD [95% CI] 0.4 [-0.6 to 1.5]). The time taken for HTS during ACT was significantly shorter (MD [95% CI] 14.7 [9.8 to 19.6]).
Conclusions: In this pilot study, HTS before ACT was no more effective than HTS during ACT as measured by lung clearance index (LCI).
Objectives: This study hypothesised that HTS before ACT would be more effective than HTS during ACT as measured by lung clearance index (LCI).
Methods: Adults with CF providing written informed consent were randomised to a crossover trial of HTS before ACT or HTS during ACT on consecutive days. ACT treatment consisted of Acapella® Duet. Patients completed LCI and spirometry at baseline and 90 mins post treatment. Mean difference (MD) and 95% confidence intervals (95% CI) were reported.
Results: 13 subjects completed the study (mean [SD] age 33 [12] years, FEV1% predicted 51% [22], LCI (no. turnovers) 14 [4]). Comparing the two treatments (HTS before ACT vs HTS during ACT), the change from baseline to 90 mins post treatment in LCI (MD [95% CI] -0.02 [-0.63 to 0.59]) and FEV1% predicted (MD [95% CI] -0.25 [-2.50 to 1.99]) was not significant. There was no difference in sputum weight (MD [95% CI] -3.0 [-14.9 to 8.9]), patient perceived ease of clearance (MD [95% CI] 0.4 [-0.6 to 1.3) or satisfaction (MD [95% CI] 0.4 [-0.6 to 1.5]). The time taken for HTS during ACT was significantly shorter (MD [95% CI] 14.7 [9.8 to 19.6]).
Conclusions: In this pilot study, HTS before ACT was no more effective than HTS during ACT as measured by lung clearance index (LCI).
| Original language | English |
|---|---|
| Article number | e000168 |
| Journal | BMJ Open Respiratory Research |
| Volume | 4 |
| Issue number | 1 |
| DOIs | |
| Publication status | Published - 12 Jan 2017 |
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Bradley, J., O'Neill, K., Moran, F., Tunney, M. M., Elborn, J. S., Bradbury, I., Downey, D. G., & Rendall, J. (2017). The timing of hypertonic saline (HTS) and airway clearance techniques (ACT) in adults with Cystic Fibrosis (CF) during pulmonary exacerbation: Pilot data from a randomised crossover study. BMJ Open Respiratory Research, 4(1), [e000168]. https://doi.org/10.1136/bmjresp-2016-000168