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(Chest. 2004;125:1507-1511.)
© 2004 American College of Chest Physicians

Pulmonary Function and Sputum Production in Patients With Cystic Fibrosis*

A Pilot Study Comparing the PercussiveTech HF Device and Standard Chest Physiotherapy

John H. Marks, MD, FCCP; Karyl L. Hare, RN, CDE; Robert A. Saunders, RRT and Douglas N. Homnick, MD, MPH, FCCP

* From the Pediatric Pulmonary Division, Department of Pediatrics, Michigan State University, Kalamazoo Center for Medical Studies (Drs. Marks and Homnick, and Ms. Hare), and Pulmonary Function Laboratory, Bronson Methodist Hospital (Mr. Saunders), Kalamazoo, MI.

Correspondence to: John H. Marks, MD, FCCP, Department of Pediatrics, Michigan State University, Kalamazoo Center for Medical Studies, 1000 Oakland Dr, Kalamazoo, MI 49008; e-mail: marks{at}kcms.msu.edu

Study objective: To compare the PercussiveTech HF (PTHF) device (Vortran Medical Technology 1; Sacramento, CA) to standard manual chest physiotherapy (CPT) with respect to acute changes in pulmonary function, sputum production, and pulse oximetry in patients with cystic fibrosis (CF).

Design: Randomized crossover.

Setting: University-affiliated, community-based CF center.

Participants: Ten clinically stable patients with CF (age range, 10 to 21 years; mean age, 15.3 years) with Shwachman scores from 55 to 95 (mean 75).

Interventions: Two treatment regimens were used: 2.5 mg of albuterol delivered via updraft nebulizer followed by standard CPT, and 2.5 mg of albuterol delivered via the PTHF device without CPT.

Results: Outcome measures included pulmonary function test (PFT) results 4 h after treatment and quantitative sputum production during the 4 h after treatment. Pulse oximetry was performed during treatment. A patient satisfaction questionnaire was administered at the end of the study. No PFT parameters were significantly changed 4 h after CPT or PTHF, although there was a trend to decreasing residual volume after both treatments. There was a trend for more sputum production after PTHF compared to CPT, but this did not reach statistical significance. There were no episodes of hemoglobin-oxygen desaturation during or after either treatment. One patient had minor hemoptysis after CPT. No adverse effects occurred after PTHF. Eight patients found the PTHF device easy to use, and six patients would prefer the PTHF device to CPT.

Conclusions: The PTHF device appears to be a safe and effective method of airway clearance in CF patients in this small pilot study.

Key Words: chest physiotherapy • cystic fibrosis • intrapulmonary percussion • mucus clearance • pulmonary function






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