title: Short-Term Effect of Autogenic Drainage on Ventilation Inhomogeneity in Adult Subjects With Stable Non-Cystic Fibrosis Bronchiectasis.
abstract: BACKGROUND
  Lung clearance index (LCI), a measure of ventilation inhomogeneity derived from a multiple-breath washout test, is a promising tool for assessing airway function in patients with non-cystic fibrosis bronchiectasis. However, it is unknown whether ventilation inhomogeneity could improve after successful elimination of excessive secretions within bronchiectasis. The objective of this work was to assess the short-term effects of lung secretion clearance using the autogenic drainage technique on standard lung function tests and LCI in subjects with non-cystic fibrosis bronchiectasis.
  
  
  METHODS
  Nitrogen-based multiple-breath washout, spirometry, and body plethysmography tests were performed 30 min before autogenic drainage in adults with stable non-cystic fibrosis bronchiectasis. The autogenic drainage session was followed by a 5-min break, after which the tests were repeated in the same order. Sputum expectorated during autogenic drainage was quantified as dry weight and correlated with change between post- and pre-measurements (Δ). Pairedttest or Wilcoxon signed-rank tests were used to compare pre- and post-autogenic drainage measurement outcomes. APvalue of ≤.05 was considered as statistically significant.
  
  
  RESULTS
  Twenty-four subjects were studied (18 females, median age [range]: 65 [21-81] y). Mean ± SD LCI significantly improved after autogenic drainage (10.88 ± 2.62 vs 10.53 ± 2.35,P= .042). However, only 20% of subjects with mucus hyperproduction during autogenic drainage had a ΔLCI that exceeded measurement variability. The percent of predicted slow vital capacity (SVC%) also slightly improved (88.7 ± 19.3% vs 90 ± 19.1%,P= .02). ΔLCI was inversely related to dry sputum weight (r = -.48,P= .02) and ΔSVC% (r = -.64,P= .001). ΔSVC% also correlated with dry sputum weight (r = 0.46,P= .02).
  
  
  CONCLUSIONS
  In adults with non-cystic fibrosis bronchiectasis and mucus hypersecretion, autogenic drainage improved ventilation inhomogeneity. LCI change may be the result of the maximum recruited lung volume and the amount of cleared mucus secretion. (ClinicalTrials.gov registration NCT02411981.).
authors.affiliation: Department of Pneumology williamponcin8@gmail.com.|Université Catholique de Louvain (UCL), Institute of Experimental and Clinical Research, Pole of Pneumology, ENT, and Dermatology, Brussels, Belgium.
authors.forename: William
authors.initials: W
authors.lastname: Poncin
authors.affiliation: Department of Pneumology.|Department of Physical Medicine and Rehabilitation.|Université Catholique de Louvain (UCL), Institute of Experimental and Clinical Research, Pole of Pneumology, ENT, and Dermatology, Brussels, Belgium.
authors.forename: Grégory
authors.initials: G
authors.lastname: Reychler
authors.affiliation: Department of Pneumology.
authors.forename: Noémie
authors.initials: N
authors.lastname: Leeuwerck
authors.affiliation: Department of Physical Medicine and Rehabilitation.|Cystic Fibrosis Unit, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Brussels, Belgium.
authors.forename: Nathalie
authors.initials: N
authors.lastname: Bauwens
authors.affiliation: Department of Physical Medicine and Rehabilitation.|Cystic Fibrosis Unit, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Brussels, Belgium.|Université Catholique de Louvain (UCL), Institute of Experimental and Clinical Research, Pole of Pneumology, ENT, and Dermatology, Brussels, Belgium.
authors.forename: Anne-Sophie
authors.initials: AS
authors.lastname: Aubriot
authors.affiliation: Department of Pneumology.
authors.forename: Candice
authors.initials: C
authors.lastname: Nader
authors.affiliation: Department of Pneumology.|Université Catholique de Louvain (UCL), Institute of Experimental and Clinical Research, Pole of Pneumology, ENT, and Dermatology, Brussels, Belgium.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Liistro
authors.affiliation: Department of Pneumology.|Cystic Fibrosis Unit, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Brussels, Belgium.|Université Catholique de Louvain (UCL), Institute of Experimental and Clinical Research, Pole of Pneumology, ENT, and Dermatology, Brussels, Belgium.
authors.forename: Sophie
authors.initials: S
authors.lastname: Gohy
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001987:Bronchiectasis / Q000503:physiopathology / Q000628:therapy*; D015916:Drainage, Postural / Q000379:methods*; D005260:Female; D006801:Humans; D008168:Lung / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D009093:Mucus / Q000378:metabolism; D011446:Prospective Studies; D012123:Pulmonary Ventilation / Q000502:physiology*; D012129:Respiratory Function Tests; D012138:Respiratory Therapy / Q000379:methods*; D013147:Spirometry; D013183:Sputum / Q000378:metabolism; D016896:Treatment Outcome; D014797:Vital Capacity / Q000502:physiology; D055815:Young Adult
keywords: airway clearance technique; autogenic drainage; bronchiectasis; chest physiotherapy; lung clearance index; lung function tests