[Influence of an oscillating physiotherapy device (RC-Cornet trade mark) on the regional distribution of the pulmonary aerosol deposition in patients with COPD]

Abstract

Background: The inhalation of ipratropium bromide via a jet nebulizer obtained a significantly higher bronchodilation, if the oscillating physiotherapy device RC-Cornet trade mark was integrated into the exaspiratory limb of the nebulizer. Therefore we investigated the influence of the RC-Cornet trade mark on the central pulmonary radioaerosol deposition as well as the relationship between central and peripheral lung deposition in patients with chronic obstructive lung disease in a controlled study.

Methods: Lung ventilation scintigraphy was performed routinely in 14 pat. with COPD (Nebulizer: PARI VECTOR trade mark, radioaerosol 500 MBq tin-colloid). At first all pat. inhaled a single breath from the nebulizer, afterwards the lungs were scanned with a planar gamma camera. Both groups (biometric and lung function data were identical) then inhaled another 5 breaths. In group A the RC-Cornet trade mark was inserted into the exaspiratory limb, in group B a normal exaspiratory valve. Once more lung scans were collected. Evaluation of the scans by means of a "region of interest" technique, dividing the lungs in a central and a peripheral area. Measuring of the radioactivity (impulse) per pixel and determination of the penetration index (PI).

Results: The following 5 breaths led to a significant increase of the central aerosol deposition (i. e. decrease of PI) in comparison with the measuring after the first breath in both groups (A 0,41 +/- 0,07 to 0,38 +/- 0,08, p = 0,04; B 0,38 +/- 0,08 to 0,34 +/- 0,11, p = 0,02). However, no difference could be recognized between the groups. No significant difference was seen with respect to the impulses per pixel.

Conclusion: Neither the aerosol deposition in the central region of the lung nor the relation between central and peripheral deposition (PI) differs between the both groups. The effect of the RC-Cornet trade mark mentioned in the introduction seems to be caused by physiotherapeutic induced changes of the mucus transport and not by an enhanced central drug deposition.