This technique has been shown to create sustained airflow that is higher than usual in the airways of the lungs. The cycle starts in the expiratory reserve volume and moves through functional residual capacity into the inspiratory reserve volume in three defined stages. 9– 13 Performing AD involves taking tidal volume breaths, with inspiratory pauses, using controlled inspiratory and expiratory effort, over the vital capacity of the lungs. 5– 7Īutogenic drainage (AD), an airway clearance technique (ACT) recognized by the International Physiotherapy Group for CF, 8 was developed by Jean Chevaillier in 1967, 9– 11 based on emerging theories and models of airflow in the lungs. 3 It is recommended that people with CF complete airway clearance daily to mitigate the effects of mucus retention in the lungs. 3, 4 Current evidence has indicated that CF lung disease originates in the small airways early in life therefore, it is important that CF treatments aggressively target these sites to prevent irreversible lung damage. 2, 3 This contributes to the advancement of CF lung disease as a result of chronic infection and a persistent, heightened inflammatory response that progressively damages the structure and architecture of the smaller airways. 1 People with CF have altered pulmonary mucus composition and are prone to secretion retention in the lungs.
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Il faudrait envisager d'utiliser le VEMS 1 comme mesure première de l'effet du DA.Ĭystic fibrosis (CF) is an inherited, life-limiting, multi-system disease that primarily affects the respiratory and digestive systems. L'effet du DA sur le fonctionnement de l'appareil pulmonaire demeure incertain et des questions ont surgi au sujet de la pertinence du VEMS 1 comme mesure valide du dégagement des voies aériennes à partir des régions pulmonaires périphériques. Conclusion: Il a été démontré, dans un nombre limité d'enquêtes, que le DA produit des volumes cliniquement significatifs de crachat. Des études de longue durée n'avaient pas le pouvoir nécessaire pour détecter tout changement du VEMS 1, mais des études de courte durée ont constaté une production cliniquement significative de crachat (≥4 grammes). Toutes les études ont mesuré le volume expiratoire maximum seconde (VEMS 1) et n'ont constaté aucun changement. On a inclus finalement quatre études dont deux à long terme. 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 ». 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).
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Further consideration should be given to the use of FEV 1 as a primary measure of the effect of AD.
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The effect of AD on the function of the pulmonary system remains uncertain, and questions have emerged regarding the appropriateness of FEV 1 as a valid measure of airway clearance from peripheral lung regions. Conclusion: AD has been shown to produce clinically significant sputum yields in a limited number of investigations. The long-term studies were underpowered to detect change in FEV 1 however, the short-term studies found a clinically significant sputum yield (≥4 g). All measured forced expiratory volume in 1 second (FEV 1) and found no change. Ultimately, 4 studies, 2 of which were long term, were included. 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. 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. 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).