[Evaluation of autodrainage methods in a selected group of cystic fibrosis patients with home environment factors taken into consideration]

Abstract

The aim of the study was an estimation of effectiveness of selected autodrainage methods used in the treatment of children with cystic fibrosis and an assessment of patients' preference in relation to investigated methods. We also estimated the patients and their families' relation to chest physiotherapy methods, which have been used at home for many years. We studied 17 patients, aged 10-18 (x 13.35), who were hospitalised in the Institute of Mother and Child Paediatric Clinical Dept. We compared four autodrainage methods: 1- force expiratory technique, 2- Flutter(R), 3- Flutter (R) with relaxation, 4- PEP system. Every investigated drainage methods were tested by each patient according to a determined procedure. The following indices were measured: weight of coughed up sputum, oxygen saturation (SaO2) before, during and after drainage, peak expiratory flaw (PEF) before and after drainage. Patients' relation to autodrainage methods was estimated on the ground of their subjective assessment in 0-5-point scale. The results showed that the force expiration technique and the Flutter(R) with relaxation are the most efficient autodrainage methods determined by their coughed up sputum weight. Patients using these methods coughed up x 1.36g and x 1.319 g sputum. Using Flutter(R) without relaxation, patients expectorated 1.199 g sputum. PEP system turned out the least effective. Patients using the PEP system coughed up x 0.87 g sputum. In comparison, patients using postural drainage with clapping expectorated x 0.63g sputum. We observed that the PEF decreased during every investigated drainage methods. There were no significant differences in SaO2 values before and after drainage. Concerning the patients' preference in relation to the investigated methods, patients appreciated the most force expiratory technique (68 points). The least appreciated was the PEP system (33 points). For comparison, postural drainage with clapping has been estimated at 48.87 points.