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. 2015 Fall;67(4):319-26.
doi: 10.3138/ptc.2014-64.

Effects of Autogenic Drainage on Sputum Recovery and Pulmonary Function in People with Cystic Fibrosis: A Systematic Review

Kimbly Morgan  1 , Kristin Osterling  1 , Robert Gilbert  2 , Gail Dechman  1
Affiliations

Effects of Autogenic Drainage on Sputum Recovery and Pulmonary Function in People with Cystic Fibrosis: A Systematic Review

Kimbly Morgan et al. Physiother Can. 2015 Fall.

Abstract
in English, French

Purpose: To determine the effects of short- and long-term use of autogenic drainage (AD) on pulmonary function and sputum recovery in people with cystic fibrosis (CF).

Methods: The authors conducted a systematic review of randomized and quasi-randomized clinical trials in which participants were people with CF who use AD as their sole airway clearance technique.

Results: Searches in 4 databases and secondary sources using 5 key terms yielded 735 articles, of which 58 contained the terms autogenic drainage and cystic fibrosis. Ultimately, 4 studies, 2 of which were long term, were included. All measured forced expiratory volume in 1 second (FEV1) and found no change. The long-term studies were underpowered to detect change in FEV1; however, the short-term studies found a clinically significant sputum yield (≥4 g).

Conclusion: AD has been shown to produce clinically significant sputum yields in a limited number of investigations. The effect of AD on the function of the pulmonary system remains uncertain, and questions have emerged regarding the appropriateness of FEV1 as a valid measure of airway clearance from peripheral lung regions. Further consideration should be given to the use of FEV1 as a primary measure of the effect of AD.

Objet: Déterminer les effets de l'utilisation à court et à long terme du drainage autogène (DA) sur la fonction pulmonaire et la récupération de crachat chez les personnes qui ont la fibrose kystique (FK). Méthodes: Les auteurs ont procédé à un examen systématique d'essais cliniques randomisés et quasi-randomisés où les participants étaient des personnes vivant avec la FK qui utilisent le DA comme seule méthode de dégagement des voies aériennes (DVA) Résultats: Les recherches effectuées dans quatre bases de données et des sources secondaires au moyen de cinq termes clés ont produit 735 articles dont 58 contenaient les expressions « drainage autogène » et « fibrose kystique ». On a inclus finalement quatre études dont deux à long terme. Toutes les études ont mesuré le volume expiratoire maximum seconde (VEMS1) et n'ont constaté aucun changement. Des études de longue durée n'avaient pas le pouvoir nécessaire pour détecter tout changement du VEMS1, mais des études de courte durée ont constaté une production cliniquement significative de crachat (≥4 grammes). Conclusion: Il a été démontré, dans un nombre limité d'enquêtes, que le DA produit des volumes cliniquement significatifs de crachat. L'effet du DA sur le fonctionnement de l'appareil pulmonaire demeure incertain et des questions ont surgi au sujet de la pertinence du VEMS1 comme mesure valide du dégagement des voies aériennes à partir des régions pulmonaires périphériques. Il faudrait envisager d'utiliser le VEMS1 comme mesure première de l'effet du DA.

Keywords: airway obstruction; autogenic drainage; cystic fibrosis; outcome measures; systematic review.

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Figures

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Figure 1
Flow diagram.
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References

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