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Published on: April 6, 2017
Effect of an airway clearance technique on nebulized drug delivery in patients with CF: A randomized cross-over trial
Gregory Reychler1, Teresinha Leal2, Sophie Gohy3
1Institut de Recherche Expérimentale et Clinique (IREC), Pôle de Pneumologie, ORL & Dermatologie, Université Catholique de Louvain, Avenue Hippocrate 10, Brussels 1200, Belgium; Service de Pneumologie, Cliniques universitaires Saint-Luc, Avenue Hippocrate 10, Brussels 1200, Belgium; Service de kinésithérapie et ergothérapie, Cliniques universitaires Saint-Luc, Avenue Hippocrate 10, Brussels 1200, Belgium.
Objectives:
The aim of this study was to verify the efficacy of airway clearance technique on drug delivery by nebulization.
Design:
Cross-over study.
Participants:
Stable patients with CF (PwCF) (n=8).
Interventions:
Participants performed the airway clearance technique before or after the nebulization session. The Autogenic Drainage (AD) was the executed airway clearance techniques. The nebulization session was a delivery of 500 mg-amikacin with the AKITA®.
Main Outcome Measures:
The primary endpoint was the 24 h-urinary excretion of amikacin.
Results:
PwCF were between 18 and 48 years old (FEV1: 43 to 92 %), all colonized by Pseudomonas aeruginosa, and all with bronchiectasis. Irrespective of the order of the nebulization and the physiotherapy sessions, the total amount of urinary amikacin excretion was similar (Median Difference (95%CI): 0 (-7 to 4)% of the nominal dose). The elimination constant rate for nebulization before (Median: 0.153 (IQR: 0.071 to 0.205)) and after the airway clearance technique (0.149 (0.041 to 0.182); p = 0.26) were similar (Median difference (95%CI): 0.02 (-0.004 to 0.023)).
Conclusions:
The lung delivery of nebulized medication in PwCF colonized with Pseudomonas aeruginosa was not improved by the order of the airway clearance and nebulization procedures. CONTRIBUTION OF THE PAPER.
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