Physiotherapy · 2025
Impact of adding positive expiratory pressure to nebulisation on drug delivery: a comparative study.
СтатьяРандомизированное исследованиеСравнительное исследованиеПоддержка исследования: вне правительства СШАНазвание и аннотация: Перевод пока не подготовлен
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Aubriot Anne-Sophie, Leal Teresinha, Dubus Jean-Christophe, Gohy Sophie, Reychler Gregory
Аннотация
OBJECTIVE: To assess the impact of combining positive expiratory pressure (PEP) and nebulisation on lung delivery by measuring the urinary concentration of amikacin, used as a biomarker in people with cystic fibrosis.
DESIGN: Randomised crossover study.
PARTICIPANTS: Nine people with cystic fibrosis.
INTERVENTION: A solution of amikacin was nebulised using a nebuliser alone or a nebuliser in combination with a PEP device.
OUTCOME MEASURES: After nebulisation, urine samples were collected over 24 hours. The total amount of amikacin excreted in urine was calculated, reflecting the lung dose. The elimination rate constant was also calculated, and represents total drug elimination by excretion and metabolism.
RESULTS: No differences in lung dose, half-life or elimination rate constant were observed between the two methods of nebulisation. Lung dose divided by respiratory rate was significantly greater for nebulisation in combination with PEP.
CONCLUSION: The use of nebulisation in combination with PEP does not result in clinically significant improvements in drug delivery in people with mild-to-moderate cystic fibrosis. However, this combination can be used safely to reduce the duration of physiotherapy sessions without compromising drug delivery.
TRIAL REGISTRATION: NCT02535130. CONTRIBUTION OF THE PAPER.
DESIGN: Randomised crossover study.
PARTICIPANTS: Nine people with cystic fibrosis.
INTERVENTION: A solution of amikacin was nebulised using a nebuliser alone or a nebuliser in combination with a PEP device.
OUTCOME MEASURES: After nebulisation, urine samples were collected over 24 hours. The total amount of amikacin excreted in urine was calculated, reflecting the lung dose. The elimination rate constant was also calculated, and represents total drug elimination by excretion and metabolism.
RESULTS: No differences in lung dose, half-life or elimination rate constant were observed between the two methods of nebulisation. Lung dose divided by respiratory rate was significantly greater for nebulisation in combination with PEP.
CONCLUSION: The use of nebulisation in combination with PEP does not result in clinically significant improvements in drug delivery in people with mild-to-moderate cystic fibrosis. However, this combination can be used safely to reduce the duration of physiotherapy sessions without compromising drug delivery.
TRIAL REGISTRATION: NCT02535130. CONTRIBUTION OF THE PAPER.