title: The influence of Flutter®VRP1 components on mucus transport of patients with bronchiectasis.
abstract: BACKGROUND
  The Flutter(®)VRP1 combines high frequency oscillation and positive expiratory pressure (PEP).
  
  
  OBJECTIVE
  To separately evaluate the effect of the Flutter(®)VRP1 components (high frequency oscillation and PEP) on mucus transportability in patients with bronchiectasis.
  
  
  METHODS
  Eighteen patients with bronchiectasis received sessions with the Flutter(®)VRP1 or PEP for 30 min daily in a randomized, crossover study. The treatment duration was four weeks with one of the therapies, one week of a "wash-out" period and followed by four more weeks with the other treatment. Weekly secretion samples were collected and evaluated for mucociliary relative transport velocity (RTV), displacement in a simulated cough machine (SCM) and contact angle measurement (CAM). For the proposed comparisons, a linear regression model was used with mixed effects with a significance level of 5%.
  
  
  RESULTS
  The Flutter(®)VRP1 treatment resulted in greater displacement in SCM and lower CAM when comparing results from the first (9.6 ± 3.4 cm and 29.4 ± 5.7°, respectively) and fourth weeks of treatment (12.44 ± 10.5 cm and 23.28 ± 6.2°, respectively; p < 0.05). There was no significant difference in the RTV between the treatment weeks for either the Flutter(®)VRP1 or PEP.
  
  
  CONCLUSIONS
  The use of the Flutter(®)VRP1 for four weeks is capable of altering the respiratory secretion transport properties, and this alteration is related to the high frequency oscillation component.
authors.affiliation: University of São Paulo, Ribeirão Preto, São Paulo, Brazil. jtambascio@yahoo.com.br
authors.forename: Joana
authors.initials: J
authors.lastname: Tambascio
authors.forename: Léa Tatiana
authors.initials: LT
authors.lastname: de Souza
authors.forename: Roberta M
authors.initials: RM
authors.lastname: Lisboa
authors.forename: Rita de Cássia V
authors.initials: Rde C
authors.lastname: Passarelli
authors.forename: Hugo Celso Dutra
authors.initials: HC
authors.lastname: de Souza
authors.forename: Ada Clarice
authors.initials: AC
authors.lastname: Gastaldi
mesh_terms: D001987:Bronchiectasis / Q000503:physiopathology* / Q000628:therapy; D035641:Chest Wall Oscillation / Q000295:instrumentation* / Q000379:methods; D018592:Cross-Over Studies; D004867:Equipment Design; D005260:Female; D006801:Humans; D016014:Linear Models; D008168:Lung / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D009079:Mucociliary Clearance; D009093:Mucus; D011175:Positive-Pressure Respiration / Q000295:instrumentation / Q000379:methods; D016896:Treatment Outcome; D014732:Vibration