title: Effect of slow expiration with glottis opened in lateral posture (ELTGOL) on mucus clearance in stable patients with chronic bronchitis.
abstract: BACKGROUND
  Slow expiration with glottis opened in lateral posture (ELTGOL, l'expiration lente totale glotte ouverte en infralatéral) has been used in clinical practice to improve mucus clearance from peripheral airways. The purpose of this crossover study was to evaluate  the effect of ELTGOL on mucus clearance of right and left lungs, especially of peripheral lung areas, in stable patients with chronic bronchitis.
  
  
  METHODS
  Twelve 45-75-year-old patients with chronic bronchitis were studied (10 of whom had mild to moderate COPD according to the Global  Initiative for Chronic Obstructive Lung Disease guidelines). Control and ELTGOL interventions were performed on a randomized allocation of subjects. Mucus clearance was measured through 6 posterior scintigraphy images taken with the patient in the right lateral decubitus position 20 (T1),  40 (T2), 60 (T3), 80 (T4), and 120 (T5) min after baseline image (T0). In the control intervention only ventilatory scintigraphy measurements were performed. During ELTGOL the technique was performed after the baseline image (T0).
  
  
  RESULTS
  Significant increases in mucus clearance from the  peripheral area were found only in the right lung, and were observed at all times during ELTGOL (P < .05) except T1. Significant increases in mucus clearance were observed at all times studied in the total area of the right lung and in the left lung at T1 and T2. For the intermediate  area and central areas, results were similar in both lungs.
  
  
  CONCLUSIONS
  ELTGOL was efficient in increasing peripheral airway clearance in dependent lung of patients with chronic bronchitis, most of them with mild to moderate COPD.
authors: Universidade Federal de Minas Gerais, Minas Gerais, Brazil.
authors: Jocimar Avelar
authors: JA
authors: Martins
authors: Armèle
authors: A
authors: Dornelas de Andrade
authors: Raquel Rodrigues
authors: RR
authors: Britto
authors: Rovilson
authors: R
authors: Lara
authors: Verônica Franco
authors: VF
authors: Parreira
mesh_terms: D000368:Aged; D001991:Bronchitis / Q000453:epidemiology / Q000503:physiopathology*; D002908:Chronic Disease; D015897:Comorbidity; D018592:Cross-Over Studies; D045853:Exhalation / Q000502:physiology*; D005260:Female; D005931:Glottis / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009093:Mucus / Q000378:metabolism*; D029424:Pulmonary Disease, Chronic Obstructive / Q000453:epidemiology; D014939:Work of Breathing