A Functional Respiratory Imaging Approach to the Effect of an Oscillating Positive Expiratory Pressure Device in Chronic Obstructive Pulmonary Disease

Abstract

Purpose

Chronic obstructive pulmonary disease (COPD) patients are prone to suffer from chronic bronchitis, which ultimately affects their quality of life and overall prognosis. Oscillating positive expiratory pressure (oPEP) devices are designed to aid in the mucus clearance by generating positive pressure pulses in the airways. The main aim of this study was to analyze the impact of a specific oPEP device – Aerobika ^® – on top of standard of care medication in COPD patients’ lung dynamics and drug deposition.

Patients and Methods

In this single-arm pilot study, patients were assessed using standard spirometry tests and functional respiratory imaging (FRI) before and after a period of 15±3 days of using the oPEP device twice daily (before their standard medication).

Results

The utilization of the oPEP device led to a significant increase of 2.88% in specific airway volume after two weeks (1.44 (SE: 0.18) vs 1.48 (SE: 0.19); 95% CI = [0.03%,5.81%]; p=0.048). Moreover, the internal airflow distribution (IAD) was affected by the treatment: patients’ changes ranged from −6.74% to 4.51%. Furthermore, IAD changes at the lower lobes were also directly correlated with variations in forced expiratory volume in one second and peak expiratory flow; conversely, IAD changes at the upper lobes were inversely correlated with these clinical parameters. Interestingly, this change in IAD was significantly correlated with changes in lobar drug deposition ( r ²=0.30, p<0.001).

Conclusion

Our results support that the Aerobika device utilization leads to an improved airflow, which in turn causes a shift in IAD and impacts the drug deposition patterns of the concomitant medication in patients with COPD.

Journal

Journal ID (nlm-ta): Int J Chron Obstruct Pulmon Dis

Journal ID (iso-abbrev): Int J Chron Obstruct Pulmon Dis

Journal ID (publisher-id): COPD

Journal ID (pmc): copd

Title: International Journal of Chronic Obstructive Pulmonary Disease

Publisher: Dove

ISSN (Print): 1176-9106

ISSN (Electronic): 1178-2005

Publication date (Electronic): 04 June 2020

Publication date Collection: 2020

Volume: 15

Pages: 1261-1268

Affiliations

[1 ]Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, University of Antwerp , Antwerp, Wilrijk, Belgium

[2 ]FLUIDDA nv , Antwerp, Kontich, Belgium

[3 ]Trudell Medical International , London, Ontario, Canada

[4 ]Faculty of Medicine and Health Sciences, University of Antwerp , Antwerp, Wilrijk, Belgium

Author notes

Correspondence: Glenn Leemans Faculty of Medicine and Health SciencesUniversity of Antwerp ,Universiteitsplein 1, 2610 Wilrijk, Antwerp, BelgiumTel [phone] Email [e-mail]

Article

Publisher ID: 242191

DOI: 10.2147/COPD.S242191

PMC ID: 7280059

Copyright statement: © 2020 Leemans et al.

License:

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Page count

Figures: 3, Tables: 3, References: 22, Pages: 8

Funding

The study was funded by Trudell Medical International.

Categories

Subject: Original Research