There are several airway clearance techniques (ACT) for effective sputum expectoration, including the active cycle of breathing technique, autogenic drainage, postural drainage, positive expiratory pressure (PEP) devices use, high-frequency chest wall oscillation, and intrapulmonary percussion ventilation ( 4). Accordingly, the treatment goal of bronchiectasis seeks to reduce respiratory symptoms and prevent exacerbations by promoting airway clearance ( 1). The emerging concept of vortex model suggests that each component of pathophysiological process interacts with all the other components, which might better explain the heterogeneity of non-cystic fibrosis bronchiectasis and its response to various treatments ( 2, 3). Dysfunction of airway clearance disrupts normal host defense, and leads to frequent infection, chronic inflammation of the bronchial tree, and progressive remodeling and destruction of the airways. Non-cystic fibrosis bronchiectasis (hereafter referred to as bronchiectasis) is a chronic respiratory disease characterized by irreversible bronchial dilatation and chronic respiratory symptoms such as cough, sputum expectoration, and dyspnea ( 1). Twice-daily physiotherapy with OPEP device in patients with bronchiectasis who have frequent exacerbations may facilitate symptomatic improvement and prevention of acute exacerbations without serious adverse events. There were no major adverse events related to the use of OPEP devices. The largest sputum volume was observed 3 months after OPEP device use (baseline: 10 ml, 3rd month 25 ml, p = 0.325). Additionally, Bronchiectasis Health Questionnaire score changed from 58.7 to 66.6, showing significant improvement over the treatment period ( p < 0.001). Of all enrolled patients, only two acute exacerbations occurred during the study period, indicating a significant decrease compared with the number of acute exacerbations before the device use ( p < 0.001). We evaluated the prevention of acute exacerbations, subjective symptom improvement, and change in sputum amount during the use of the Aerobika (Trudell Medical International, London, ON) OPEP device twice daily for 6 months.

This open-label, single-arm, prospective study included 17 patients who experienced three or more acute exacerbations in the past year.

We aimed to evaluate whether an oscillating positive expiratory pressure (OPEP) device could allow effective sputum expectoration and prevent acute exacerbations in patients with bronchiectasis who had frequent acute exacerbations. Impaired airway clearance in patients with non-cystic fibrosis bronchiectasis causes frequent bacterial infection, chronic inflammation, and progressive tissue destruction. 8Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.7Division of Pulmonary Medicine, Department of Internal Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Republic of Korea.6Division of Pulmonary Medicine and Allergy, Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Republic of Korea.5Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Internal Medicine, Hallym University Kangnam Sacred Heart Hospital, Seoul, Republic of Korea.4Artificial Intelligence Center, Chungbuk National University Hospital, Cheongju, Republic of Korea.

3Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Chungbuk National University Hospital, Chungbuk National University College of Medicine, Cheongju, Republic of Korea.

2Department of Biochemistry, Chungbuk National University College of Medicine, Cheongju, Republic of Korea.

1Department of Internal Medicine, Chungbuk National University Hospital, Chungbuk National University College of Medicine, Cheongju, Republic of Korea.

So Rae Kim 1,2 † Sun-Hyung Kim 3 † Geun-Hyeong Kim 4 Jun Yeun Cho 3 Hayoung Choi 5 Hyun Lee 6 Seung Won Ra 7 Ki Man Lee 3 Kang Hyeon Choe 3 Yeon-Mok Oh 8 Yoon Mi Shin 3 * ‡ Bumhee Yang 3 ‡

Copd flutter device