Eltgol Acutelly Improves Airway Clearance and Reduces Static Pulmonary Volumes in Adult Cystic Fibrosis Patients

Abstract

Chest physical therapy techniques are essential in order to reduce the frequency of recurrent pulmonary infections that progressively affect lung function in cystic fibrosis patients. Recently, ELTGOL (L’Expiration Lente Totale Glotte Ouverte en décubitus Latéral) emerged as an inexpensive and easy to perform therapeutic option. The aim of this study was to compare the acute effects of ELTGOL and the Flutter valve in stable adult patients with cystic fibrosis. [Subjects and Methods] This was a randomized, crossover study with a sample of cystic fibrosis outpatients. The subjects underwent two protocols (Flutter Valve and ELTGOL interventions, referred to as ELTGOL and FLUTTER) in a randomized order with a one-week washout interval between them. The main outcomes were pulmonary function variables and expectorated sputum dry weight. [Results] ELTGOL cleared 0.34 g more of secretions than FLUTTER (95% CI 0.11 to 0.57). When comparing the physiological effects of ELTGOL and FLUTTER, the first was superior in improving airway resistance (−0.51 cmH2O/L/s; 95% CI −0.88 to −0.14) and airway conductance (0.016 L/s/cmH2O; 95% CI 0.008 to 0.023). [Conclusion] ELTGOL promoted higher secretion removal and improvement in airway resistance and conductance than the Flutter valve. These techniques were equivalent in reducing the pulmonary hyperinflation and air trapping in cystic fibrosis patients.

Long-term benefits of airway clearance in bronchiectasis: a randomised placebo-controlled trial

“…This reduction in diameter results from the weight of the superolateral lung and mediastine, from inferolateral hemidiaphragm displacement in a cephalad direction due to compression of the viscera, and from slow and prolonged expiration, which confers the added benefit of avoiding airway collapse [12,13]. On studying the ELTGOL efficacy in a single session in 15 patients with CF and 10 patients with bronchiectasis, it was found that secretion removal was greater than that obtained with Flutter [7,14]. In a recent crossover study, three non-consecutive ELTGOL sessions over a 1-week period in 31 patients with bronchiectasis achieved a similar level of sputum expectoration (during the sessions) to that obtained with autogenic drainage, and greater expectoration than with temporary positive expiratory pressure.…”

The immediate effects of a single autogenic drainage session on ventilatory mechanics in adult subjects with cystic fibrosis

“…Pearson’s r test was used to determine correlations between the quantitative parameters. The power calculation for this study was based on data published for CF patients [ 12 ]. Using a two-sided alpha of 0.05 and a reduction of ≥0.5 cmH 2 O/L/s for Rrs 5 as statistically significant, a minimum of 36 subjects was required to provide a power of 0.8.…”

“…A previous study of FOT showed that adult CF subjects had higher resistance and reactance values compared with the healthy population, suggesting that the FOT might provide sensitive indicators of respiratory system resistive and reactance properties in CF subjects [ 11 ]. Recently, Guimaraes et al showed improvements in resistance and conductance in CF subjects, as measured by plethysmography, following respiratory physiotherapy by slow and complete expiration in the lateral posture with opened glottis (ELTGOL) or Flutter interventions [ 12 ].…”

Techniques manuelles de drainage bronchique des adultes et adolescents : quel niveau de preuve ?

“…Deux essais portent sur des BPCO hospitalisés pour exacerbation [33,37], 1 étude est orientée sur des patients atteints de mucoviscidoses [35] et une sur des patients atteints de bronchiectasies [36]. Ces 5 études compte 3 essais randomisés contrôlés(PEDro :5, 5 et 7/10).…”

“…Ces 5 études compte 3 essais randomisés contrôlés(PEDro :5, 5 et 7/10). Les résultats sont en faveur de l'ELTGOL, avec moins d'exacerbations et d'hospitalisations chez les patients atteints de BPCO [37] et une augmentation de la production d'expectorations quel que soit la pathologie concernée [33,35,36]. De plus, chez les patients atteints de mucoviscidose, l'ELTGOL améliore la résistance des voies aériennes.…”