title: Non-invasive Ventilation as Airway Clearance Technique in Cystic Fibrosis.
abstract: OBJECTIVE
  For patients with cystic fibrosis, chest physiotherapy is crucial for evacuating airway secretions. Because chest physiotherapy increases energy expenditure, fatigue and dyspnoea, non-invasive ventilation (NIV) could be beneficial for severely ill patients during airway clearance. The aim of the study is to evaluate and compare the effects between NIV and positive expiratory pressure (PEP) on airway clearance.
  
  
  METHODS
  Prospective, randomized trial compares PEP to NIV. Thirty-two subjects, mean age 31 years, mean forced expiratory volume in 1 second 47% (±14) and mean forced vital capacity 69% (±13), completed a 3-month randomized trial comparing NIV with standard PEP treatment as airway clearance technique. Lung functions testing, 6-minute walk test, blood gases, sputum culture and inflammatory parameters were measured before and after the treatment period.
  
  
  RESULTS
  There was a significant reduction in lung clearance index (LCI) following NIV compared with PEP (p = 0.01). LCI is performed within the lung function testing.
  
  
  CONCLUSIONS
  Non-invasive ventilation was shown to be a good alternative to PEP in chest physiotherapy for patients with cystic fibrosis who are severely ill.
authors.affiliation: Department of Physical Therapy, Karolinska University Hospital, Huddinge, Sweden.|Department of Clinical Science, Intervention and Technology, CLINTEC, Karolinska Institutet, Stockholm, Sweden.|Stockholm CF Center, Karolinska University Hospital, Stockholm, Sweden.
authors.forename: Maria Cecilia
authors.initials: MC
authors.lastname: Rodriguez Hortal
authors.affiliation: Department of Physical Therapy, Karolinska University Hospital, Huddinge, Sweden.|Division of Physiotherapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Malin
authors.initials: M
authors.lastname: Nygren-Bonnier
authors.affiliation: Department of Clinical Science, Intervention and Technology, CLINTEC, Karolinska Institutet, Stockholm, Sweden.|Stockholm CF Center, Karolinska University Hospital, Stockholm, Sweden.
authors.forename: Lena
authors.initials: L
authors.lastname: Hjelte
mesh_terms: D000293:Adolescent; D000328:Adult; D003550:Cystic Fibrosis / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D063087:Noninvasive Ventilation; D026741:Physical Therapy Modalities; D011175:Positive-Pressure Respiration; D011446:Prospective Studies; D012129:Respiratory Function Tests; D012138:Respiratory Therapy / Q000379:methods*; D000070857:Walk Test; D055815:Young Adult
keywords: chest physiotherapy; lung clearance index; lung function testing; positive airway pressure