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Project Fizzyo: Identification of optimal pressure-length breath profiles for airway clearance techniques in children with cystic fibrosis

Filipow, Nicole; Raywood, Emma; Stanojevic, Sanja; Davies, Gwyneth; Douglas, Helen; Shannon, Harriet; Murray, Nicky; ... Main, Eleanor; + view all (2023) Project Fizzyo: Identification of optimal pressure-length breath profiles for airway clearance techniques in children with cystic fibrosis. In: European Respiratory Journal. (pp. PA4998-PA4998). European Respiratory Society: Milan, Italy. Green open access

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Abstract

Intro Airway clearance techniques (ACTs) are the most burdensome therapies for people with cystic fibrosis (CF). Effects of different techniques on clinical outcomes are unknown. Aim Identify combinations of ACT breath pressure and length that are associated with improved FEV1%predicted in children with CF. Methods Expired breaths from 145 children with CF using positive expiratory pressure (PEP) or Oscillating PEP (OPEP) devices during habitual ACTs were captured over 16months. Treatment data were summarised into mean mid-expiratory breath pressure and breath length. ACT efficacy was investigated by iteratively comparing the effect on FEV1 of all possible combinations of pressure and length against weeks with no ACTs using linear mixed effects regression models, where weekly FEV1 was extrapolated for each participant using flexible polynomials fitted to observed FEV1 data (n=1116). Results ~45K treatments (137 people,~4M breaths) and ~21K “no ACT” days (141 people) were analysed. Compared to no treatment, a significant positive association with FEV1 was observed for 3 breath profiles (32% of treatments) (Table). Breaths outside these 3 profiles had no effect. Conclusions Pressure-length breath profiles other than those normally prescribed may be facilitated by different ACT devices and may result in benefit.

Type: Proceedings paper
Title: Project Fizzyo: Identification of optimal pressure-length breath profiles for airway clearance techniques in children with cystic fibrosis
Event: Annual Congress of the European Respiratory Society (ERS)
Location: IA, Milan
Dates: 9 Sep 2023 - 13 Sep 2023
Open access status: An open access version is available from UCL Discovery
DOI: 10.1183/13993003.congress-2023.PA4998
Publisher version: http://dx.doi.org/10.1183/13993003.congress-2023.p...
Language: English
Additional information: This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions.
Keywords: Science & Technology, Life Sciences & Biomedicine, Respiratory System
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
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 > 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 > Population, Policy and Practice Dept
URI: https://discovery.ucl.ac.uk/id/eprint/10186968
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