A Comparison of 2 Respiratory Devices for Sputum Clearance in Adults With Non-Cystic Fibrosis Bronchiectasis

Abstract

Both devices were well-tolerated and successfully augmented secretion clearance. Most subjects preferred the Flutter because of increased speed of secretion clearance, and greater ease of use.

Measuring airway clearance outcomes in bronchiectasis: a review

“…Sputum volume has been assessed in airway clearance studies using different methods including sputum wet weight [41][42][43][44], dry weight [42], the volume collected during and/or immediately following an intervention [35,[41][42][43][44][45][46] or the volume collected in a 24-h period post-intervention [35,41,43]. Studies of airway clearance in bronchiectasis report variations in results on sputum volume.…”

“…Studies of airway clearance in bronchiectasis report variations in results on sputum volume. Most studies document an increase in sputum volume with use of ACTs [35,43,45,46] but some report inconsistent findings between different studies depending on when sputum volume was measured [35,42,43], while other studies found no benefit on sputum volume with different ACT interventions [41,42,44]. These variations may be due to different study populations, variations in ACTs applied and the sputum measurement time-periods.…”

“…While the measurement of sputum volume and weight would appear to be straightforward or simple, there are well-documented limitations with the collection and characterisation of sputum including the compliance required when collecting sputum weight over specific time-periods [30,47,48]. Limitations associated with the use of sputum weight include day-to-day variability, within day variability and swallowing of secretions [42]. Variables such as hydration, diet, weather and saliva contamination can also affect sputum weight [47] and the process of obtaining dry sputum weight from wet sputum weight has not been standardised [42].…”

“…Limitations associated with the use of sputum weight include day-to-day variability, within day variability and swallowing of secretions [42]. Variables such as hydration, diet, weather and saliva contamination can also affect sputum weight [47] and the process of obtaining dry sputum weight from wet sputum weight has not been standardised [42]. Airway clearance sessions or antibiotic use may increase sputum weight or volume in the short term, but actually reduce sputum weight or volume over the long term as inflammation reduces [47].…”

“…Several studies in bronchiectasis airway clearance research have included an objective measure of patient perception documented by subjects on a Likert scale or questionnaire. These questions explored the perceived effectiveness or ease of use of ACTs [41], acceptance or tolerability of ACTs [42,57,63], perceived comfort [44,55] and symptoms such as cough [57,61]. The most common question asked is patient preference for an ACT; however, this was only asked in four studies [43,56,58,63].…”