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Quantity and quality of airway clearance in children and young people with cystic fibrosis

Raywood, Emma; Shannon, Harriet; Filipow, Nicole; Tanriver, Gizem; Stanojevic, Sanja; Kapoor, Kunal; Douglas, Helen; ... Main, Eleanor; + view all (2022) Quantity and quality of airway clearance in children and young people with cystic fibrosis. Journal of Cystic Fibrosis 10.1016/j.jcf.2022.09.008. (In press). Green open access

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Abstract

Children and young people with CF (CYPwCF) get advice about using positive expiratory pressure (PEP) or oscillating PEP (OPEP) devices to clear sticky mucus from their lungs. However, little is known about the quantity (number of treatments, breaths, or sets) or quality (breath pressures and lengths) of these daily airway clearance techniques (ACTs) undertaken at home. This study used electronic pressure sensors to record real time breath-by-breath data from 145 CYPwCF (6-16y) during routine ACTs over 2 months. ACT quantity and quality were benchmarked against individual prescriptions and accepted recommendations for device use. In total 742,084 breaths from 9,081 treatments were recorded. Individual CYPwCF maintained consistent patterns of ACT quantity and quality over time. Overall, 60% of CYPwCF did at least half their prescribed treatments, while 27% did fewer than a quarter. About 77% of pre-teens did the right number of daily treatments compared with only 56% of teenagers. CYPwCF usually did the right number of breaths. ACT quality (recommended breath length and pressure) varied between participants and depended on device. Breath pressures, lengths and pressure-length relationships were significantly different between ACT devices. PEP devices encouraged longer breaths with lower pressures, while OPEP devices encouraged shorter breaths with higher pressures. More breaths per treatment were within advised ranges for both pressure and length using PEP (30-31%) than OPEP devices (1-3%). Objective measures of quantity and quality may help to optimise ACT device selection and support CYPwCF to do regular effective ACTs.

Type: Article
Title: Quantity and quality of airway clearance in children and young people with cystic fibrosis
Location: Netherlands
Open access status: An open access version is available from UCL Discovery
DOI: 10.1016/j.jcf.2022.09.008
Publisher version: https://doi.org/10.1016/j.jcf.2022.09.008
Language: English
Additional information: © 2022 The Authors. Published by Elsevier B.V. on behalf of European Cystic Fibrosis Society under a Creative Commons license (https://creativecommons.org/licenses/by-nc-nd/4.0/).
Keywords: Airway clearance techniques, Chest physiotherapy, Paediatric, Physiotherapy, Respiratory
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL GOS Institute of Child Health > Infection, Immunity and Inflammation Dept
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL GOS Institute of Child Health
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
URI: https://discovery.ucl.ac.uk/id/eprint/10157411
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