Bubble-positive expiratory pressure device and sputum clearance in bronchiectasis: A randomised cross-over study

Area of Science:

• Respiratory Medicine
• Pulmonary Rehabilitation

Background:

• Daily sputum production is common in bronchiectasis, necessitating effective airway clearance techniques.
• Bubble-positive expiratory pressure (PEP) is used for sputum clearance but lacks study in bronchiectasis.
• Comparing bubble-PEP to the active cycle of breathing technique (ACBT) and control is crucial for optimizing patient care.

Purpose of the Study:

• To compare the efficacy of bubble-PEP, ACBT, and a control (no intervention) for sputum clearance in adults with bronchiectasis.
• To evaluate sputum wet weight as the primary outcome measure across different intervention periods.

Main Methods:

• A prospective, randomized cross-over trial involving 35 adults with stable, productive bronchiectasis.
• Participants underwent 30-minute sessions of bubble-PEP, ACBT, or control in a randomized order on separate days.
• Sputum wet weight was measured during and after each intervention, with intention-to-treat analysis.

Main Results:

• No significant difference in sputum weight between bubble-PEP and ACBT during the 30-minute intervention or in total sputum weight.
• Bubble-PEP yielded significantly greater sputum wet weight compared to ACBT at 60 minutes post-intervention.
• Bubble-PEP demonstrated significantly greater sputum clearance than the control group at all measured time points.

Conclusions:

• Bubble-positive expiratory pressure (PEP) is an effective sputum clearance method for individuals with bronchiectasis.
• Bubble-PEP shows superiority over the active cycle of breathing technique (ACBT) for sputum clearance at 60 minutes post-intervention.
• Bubble-PEP can be considered a valuable alternative airway clearance technique for patients with bronchiectasis.