The effects of the addition of a new airway clearance device to chest physiotherapy in children with cystic fibrosis pulmonary exacerbations

Characteristic	CP (n=24)	CP + device (n=24)	p-value
Age, years	13 (12–16)	14 (13–17)	NS
Male, n (%)	16 (66.7)	7 (29.2)	<0.01
Height, cm	161.0±12.3	159.3±14.7	NS
BMI, kg/m²	18.9±2.5	18.2±5.9	NS
BMI z-score	–0.2±0.8	–0.9±0.9	<0.05
LCI	12.3±4.0	14.4±3.8*	<0.05
LCI z-score	(7.312.9 –19.5)	(10.915.0 –50.0)*	NS
FEV₁, % predicted	76.0±20.6	66.7±19.2	<0.05
FEV₁, L	2.4±0.9	1.9±0.8	<0.05
FVC, % predicted	87.8±18.8	77.7±18.6	<0.05
FVC, L	3.2±1.1	3.0±1.2	<0.05
FEV₁/FVC, %	86.8±10.2	77.0±14.1	<0.01
FEV₁/FVC z-score	-1.58±1.07	-2.42±1.14	<0.02
MEF25-75, % predicted	58.7±28.2	38.0±24.9	<0.01 NS
Pseudomonas aeruginosa, n (%)	8 (33)	13 (54)
F508del homozygous, n (%)	11 (46)	14 (58)	NS
Pancreatic insufficiency, n (%)	23 (96)	23 (96)	NS

Values are median (interquartile range), mean ± standard deviation, or number of patients (%).

BMI, body mass index; CP, chest physiotherapy; FEV, forced expiratory ₁volume in 1 second; FVC, forced vital capacity; LCI, lung clearance index; MEF 25-75, maximum expiratory flow at 25-75% of FVC; NS, not statistically significant.

* n=18 in the CP + device group.

Changes in forced expiratory volume in 1 second (FEV₁) with treatment in the CP (A) and CP + device (B) groups (individual patient data). Changes in forced vital capacity (FVC) with treatment in the CP (C) and CP + device (D) groups (individual patient data).

Change in maximal expiratory flow at 25% of forced vital capacity (MEF₂₅) with treatment in the CP (A) and CP + device (B) groups (individual patient data).

Table 2

Pulmonary function tests.

	CP				CP + device
	Baseline	Before discharge	Mean change from baseline to discharge	p-value	Baseline/	Before discharge	Mean change from baseline to discharge	p-value
LCI:
Mean ± SD	12.3±4.0	11.5±3.8	–0.8±2.0	0.030	14.4±3.8*	13.7±4.1*	–0.7±2.4*	NS
% change			–5.0±16.3				-4.4±13.5*
LCI z-score
Mean ± SD	19.2±22.1	18.1±24.6	-1.1±7.9	NS	29.0±27.5*	23.9±27.5*	–5.1±14.8*	NS
% change			–5.3±49.5				–10.1±21.8*
FEV₁, % predicted:
Mean ± SD	76.0±20.6	83.3±19.9	7.3±12.0	0.007	66.7±19.2	69.6±23.5	9.0±9.1	<0.001
% change			11.5±17.5				14.3±14.2
FVC, % predicted
Mean ± SD	87.8±18.8	91.1±16.9	3.3±6.9	0.030	77.7±18.6	83.2±20.4	5.5±8.1	0.003
% change			4.4±7.7				7.1±11.2
FEV₁/FVC, %
Mean ± SD	86.8±10.2	91.6±8.2	4.8±9.0	0.003	77.0±14.1	82.2±16.5	5.0±6.0	<0.001
% change			6.6±14.1				7.7±7.8
FEV₁/FVC z-score
Mean ± SD	-1.58±1.07	-1.06±0.97	0.52±0.95	0.007	-2.42±1.142	-1.93±1.28	0.49±0.64	0.001
% change			-18.0±68.3				- 47.4±120.4
MEF₂₅, %	52.0±32.9	65.9±34.7	13.9±29.6	NS	29.4±20.7	41.8± 35.5	12.4±18.8	0.006
MEF₅₀, %	73.5±34.9	87.6±35.5	14.1±29.5	0.022	48.3±32.2	59.0±33.1	10.7±18.0	0.008
MEF₇₅, %	75.7±25.1	90.7±29.1	15.0±23.1	0.004	66.0±27.9	78.3±31.2	12.3±18.2	0.003
MEF_25-75, %	58.7±28.2	73.0±28.8	14.3±27.1	0.006	38.0±24.9	48.0±31.2	10.0±14.1	<0.002

Values are mean ± standard deviation.

CP, chest physiotherapy; FEV, forced expiratory volume in 1 second; FVC, forced vital capacity; LCI, lung clearance index; MEF_{125, 50, 75, 25-75}, maximum expiratory flow at 25, 50, 75% or 25-75% of FVC, respectively; NS, not statistically significant; SD standard deviation.

* n=18 in the CP + device group.

References

Authors

Metrics

Articles in this issue

DOI: https://doi.org/10.34763/jmotherandchild.20202403.2013.d-20-00008 | Journal eISSN: 2719-535X | Journal ISSN: 2719-6488

Journal RSS Feed

Language: English

Page range: 16 - 24

Published on: Jan 26, 2021

Published by: Institute of Mother and Child

In partnership with: Paradigm Publishing Services

Publication frequency: 1 issue per year

Keywords:

cystic fibrosis,

pulmonary exacerbation,

chest physiotherapy,

airway clearance device,

pulmonary function test,

lung clearance index

Related subjects:

Medicine,

Clinical medicine,

Pediatrics and juvenile medicine,

Paediatric haematology and oncology,

Public health

© 2021 Katarzyna Walicka-Serzysko, Magdalena Postek, Natalia Jeneralska, Aleksandra Cichocka, Justyna Milczewska, Dorota Sands, published by Institute of Mother and Child
This work is licensed under the Creative Commons Attribution 4.0 License.

Volume 24 (2020): Issue 3 (September 2020)

The effects of the addition of a new airway clearance device to chest physiotherapy in children with cystic fibrosis pulmonary exacerbations

Figures & Tables

Table 1

Figure 1

Figure 2

Table 2

Paradigm

My account