Long-term benefits of airway clearance in bronchiectasis: a randomised placebo-controlled trial

• Published in: The European respiratory journal Vol. 51; no. 1; p. 1701926
• Main Authors: Muñoz, Gerard, de Gracia, Javier, Buxó, Maria, Alvarez, Antonio, Vendrell, Montserrat
• Format: Journal Article
• Language: English
• Published: England European Respiratory Society Journals Ltd 01-01-2018
• Subjects: Aged; Bronchiectasis; Bronchiectasis - therapy; Clinical trials; Cough; Exercise Therapy; Expectorants; Female; Glottis - pathology; Humans; Inflammation; Male; Middle Aged; Posture; Quality of Life; Respiration; Respiratory function; Respiratory Function Tests; Respiratory Therapy - methods; Respiratory tract; Secretion; Severity of Illness Index; Sputum; Sputum - metabolism; Surveys and Questionnaires
• ISSN: 0903-1936; 1399-3003
• DOI: 10.1183/13993003.01926-2017

Keeping airways clear of mucus by airway clearance techniques seems essential in bronchiectasis treatment, although no placebo-controlled trials or any studies lasting longer than 3 months have been conducted. We evaluate the efficacy of the ELTGOL (slow expiration with the glottis opened in the lateral posture) technique over a 1-year period in bronchiectasis patients with chronic expectoration in a randomised placebo-controlled trial.Patients were randomised to perform the ELTGOL technique (n=22) or placebo exercises (n=22) twice-daily (ClinicalTrials.gov, NCT01578681). The primary outcome was sputum volume during the first intervention and 24 h later. Secondary outcomes included sputum volume during the intervention and 24 h later at month 12, exacerbations, quality of life, sputum analyses, pulmonary function, exercise capacity, systemic inflammation, treatment adherence, and side effects.Sputum volume during intervention and 24 h later was higher in the ELTGOL group than in the placebo group both at the beginning and end of the study. Patients in the ELTGOL group had fewer exacerbations (p=0.042) and a clinically significant improvement in the St George's Respiratory Questionnaire score (p<0.001) and the Leicester Cough Questionnaire score compared with the placebo group (p<0.001).Twice-daily ELTGOL technique over 1 year in bronchiectasis patients facilitated secretion removal and was associated with fewer exacerbations, improved quality of life, and reduced cough impact.