The effect of two techniques on the characteristics and transport of sputum in patients with bronchiectasis

Influência da técnica de pressão expiratória positiva oscilante utilizando pressões expiratórias pré-determinadas na viscosidade e na transportabilidade do escarro em pacientes com bronquiectasia

“…The absence of significant differences in terms of sputum transportability after the technique was performed at P15 and at P25 is in agreement with the results of one study, (4) despite methodological differences related to expiratory pressure and time required to perform the technique.…”

“…(5) However, it remains unclear whether these effects result in changes in the rheological properties of sputum. (4) Studies have confirmed some of the mechanisms of action of this device by analyzing the volume of sputum and the spirometric parameters. (7)(8)(9)(10) One group of authors, (4) in a pilot study of patients with bronchiectasis, evaluated the effect that two techniques, one of which being oscillating positive expiratory pressure (OPEP), have on sputum transportability and found that there was no change in transport after the use of either technique.…”

“…(4) Studies have confirmed some of the mechanisms of action of this device by analyzing the volume of sputum and the spirometric parameters. (7)(8)(9)(10) One group of authors, (4) in a pilot study of patients with bronchiectasis, evaluated the effect that two techniques, one of which being oscillating positive expiratory pressure (OPEP), have on sputum transportability and found that there was no change in transport after the use of either technique. Another group of authors, (11) in a case study of a patient with bronchiectasis, compared the effects of the use of the Flutter VRP1 ® and the use of "tapotement" (percussive tapping) on the transportability and viscoelasticity of sputum and concluded that the use of the device made sputum less viscous and therefore improved transportability.…”

“…(3) One of the bronchial hygiene techniques employed in physical therapy uses the Flutter VRP1 ® (Scandipharm, Birmingham, AL, USA), which combines high-frequency oscillation and positive expiratory pressure, and its proposed effects are preventing airway obstruction and removing the accumulation of secretion. (4) The Flutter VRP1 ® is a device containing a cone, within which there is a metallic sphere. When the patient exhales through the device, the expired airflow raises the metallic sphere, which falls again under its own weight.…”

“…(4,18) In order to perform the technique, the patients were instructed to remain seated on a chair, with their torso inclined forward (coxofemoral joint flexion at 65°), their head in a neutral position, their elbows supported on a table and their hands holding the device. When exhaling through the device, the patients could change their position in terms of torso inclination if they did not feel an intrathoracic vibration effect, which was confirmed by the therapist.…”