Validation of a protocol for airway clearance in patients with ineffective cough

Abstract

Literature describes a wide range of treatments for secretion clearance. There is, however, a lack of evidence to support any of these techniques. Several authors have shown more progress with the use of multiple techniques. The efficacy of a protocol is characterized by the combined use of 3 techniques (CPAP-Free Aspire-Cough Assist) in subjects with ineffective cough. The study was conducted in ICS MAUGERI-Veruno (NO, Italy). 10 patients with ineffective cough, bronchial encumbrance, lung parenchyma integrity and good collaboration were recruited. The protocol had a duration of 10 sessions: during each session, the patient performed 5’of CPAP, 15’ of Free Aspire and 5 cycles x 4 sequences of Cough Assist. Result measurements were: subjective perception of mucus encumbrance (VNS) and SpO2 detected at the start of each session and end of each technique, PO2/FiO2 and perceived health status (EQ-5D) detected at the start and end of the protocol. The variation of subjective perception of secretions (VNS) was tested both within the session and among the 10 treatment sessions. Statistically significant differences were found both comparing the VNS median values found at the start and end of each session (p: 0.004) and the median values found at the start and end of the protocol (p: 0.016). SpO2 values increased from the start to the end of a single session (p: 0.016). ABGT showed a not statically significant increase in the PO2/FiO2 (p: 0.094). All patients reported a remarkable improvement in perceived health status assessed with EQ-5D (p: 0.002). The protocol was effective in reducing the perception of obstruction and in improving SpO2 and quality of life