The Experts below are selected from a list of 198 Experts worldwide ranked by ideXlab platform
F.h.m. Corstens - One of the best experts on this subject based on the ideXlab platform.
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effect of positive expiratory pressure mask physiotherapy pep versus Forced Expiration technique fet pd on regional lung clearance in chronic bronchitics
European Respiratory Journal, 1991Co-Authors: M Van Hengstum, J Festen, C Beurskens, M Hankel, F Beekman, F.h.m. CorstensAbstract:On theoretical grounds it is assumed that positive expiratory pressure mask physiotherapy (PEP) as a means of promoting mucus clearance is especially effective in the more distal airways. In a randomized cross-over trial including a control measurement the effect of PEP and of the Forced Expiration technique combined with postural drainage (FET/PD) on regional lung clearance was evaluated in seven patients with chronic bronchitis and abundant sputum production (mean 32 g.day-1). PEP consisted of positive expiratory pressure mask breathing interspersed with breathing exercises, Forced Expiration manoeuvres (huffing) and, if necessary, coughing. FET consisted of breathing exercises, huffing and also, if necessary, coughing. FET was combined with PD. Following inhalation of a radio-aerosol regional lung clearance was estimated by means of gamma camera imaging. The results after PEP appeared to be not significantly different from control. The mean clearance in all three lung zones (peripheral, intermediate and inner) was largest after FET/PD as compared with PEP and control. Statistical significance (p less than 0.02) was reached only for clearance in the inner region. It is concluded that PEP has no demonstrable effect on regional lung clearance in these patients.
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Effect of positive expiratory pressure mask physiotherapy (PEP) versus Forced Expiration technique (FET/PD) on regional lung clearance in chronic bronchitics.
The European respiratory journal, 1991Co-Authors: M Van Hengstum, J Festen, C Beurskens, M Hankel, F Beekman, F.h.m. CorstensAbstract:On theoretical grounds it is assumed that positive expiratory pressure mask physiotherapy (PEP) as a means of promoting mucus clearance is especially effective in the more distal airways. In a randomized cross-over trial including a control measurement the effect of PEP and of the Forced Expiration technique combined with postural drainage (FET/PD) on regional lung clearance was evaluated in seven patients with chronic bronchitis and abundant sputum production (mean 32 g.day-1). PEP consisted of positive expiratory pressure mask breathing interspersed with breathing exercises, Forced Expiration manoeuvres (huffing) and, if necessary, coughing. FET consisted of breathing exercises, huffing and also, if necessary, coughing. FET was combined with PD. Following inhalation of a radio-aerosol regional lung clearance was estimated by means of gamma camera imaging. The results after PEP appeared to be not significantly different from control. The mean clearance in all three lung zones (peripheral, intermediate and inner) was largest after FET/PD as compared with PEP and control. Statistical significance (p less than 0.02) was reached only for clearance in the inner region. It is concluded that PEP has no demonstrable effect on regional lung clearance in these patients.
Stewart W. Clarke - One of the best experts on this subject based on the ideXlab platform.
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Regional lung clearance during cough and Forced Expiration technique (FET): effects of flow and viscoelasticity.
Thorax, 1994Co-Authors: A. Hasani, Demetri Pavia, John E. Agnew, Stewart W. ClarkeAbstract:BACKGROUND--In vitro studies have suggested that both the viscoelastic properties of lung secretions and the peak flow attained during simulated cough influence clearance. This study examines the possible association of the viscoelastic properties of sputum and maximum expiratory flow with measured effectiveness of mucus clearance induced by instructed cough and by Forced Expiration technique (FET) in patients with airways obstruction. METHODS--Nineteen patients (11 men and eight women) of mean (SE) age, % predicted FEV1, and daily sputum wet weight of 64 (2) years, 52 (6)%, and 37.5 (7.9) g respectively participated in the study. Mucus movement from proximal and peripheral lung regions was measured by an objective non-invasive radioaerosol technique. Each patient underwent three assessments: control, cough, and FET. During cough and FET, maximum expiratory flow was measured at the mouth level. Apparent viscosity and elasticity of the expectorated sputum samples were measured with a viscometer. RESULTS--Compared with the control run (mean (SE) clearance: 16 (3)%) there was an increase in clearance from the whole lung during cough (44 (5)%) and FET (42 (5)%), and also an enhanced clearance of inhaled, deposited radioaerosol from the trachea, inner and intermediate regions of the lungs, but not from the outer region. There were, however, no differences in regional clearance between cough and FET. Neither regional nor total clearance correlated with maximum expiratory flow, apparent viscosity, elasticity, or daily sputum wet weight. CONCLUSIONS--These results confirm that cough and FET both promote effective clearance but suggest that, unlike in vitro studies, sputum production and viscoelasticity, as well as maximum expiratory flow, provide no guide to clearance efficacy in humans.
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Regional Mucus Transport Following Unproductive Cough and Forced Expiration Technique in Patients With Airways Obstruction
Chest, 1994Co-Authors: A. Hasani, Demetri Pavia, John E. Agnew, Stewart W. ClarkeAbstract:It has previously been shown that unproductive coughing in both healthy subjects and patients with airways obstruction is not effective in clearing lung secretions. This study investigates the regional mucus transport in a group of subjects with airways obstruction who failed to expectorate following instructed cough and Forced Expiration technique. Fourteen patients (mean±SEM age: 68±2 years) with airways obstruction (mean±SEM percent predicted FEV 1 : 54±5; daily wet weight sputum: 9.1±2.0 g) took part in the study which was a randomized, three-way crossover within-patient design. Each patient underwent three treatment maneuvers: control, cough (30 coughs over a 10-min period), and Forced Expiration (30 Forced Expirations over a 10-min period). An objective radioaerosol technique was used to monitor regional mucus movement within the lungs of the patients. The lungs were divided arbitrarily into four regions of interest: tracheal, inner, intermediate, and outer. Peak expiratory flow rate during cough and Forced Expiration was measured at the mouth. There was no correlation between the radioaerosol clearance from all regions and (1) mean peak flow during cough and Forced Expiration, and (2) mean 24-h sputum production prior to the study day. There were no differences in regional radioaerosol clearance between cough and Forced Expiration. However, both cough and Forced Expiration resulted in significant clearance compared with control for all regions with the exception of the Forced Expiration in the outer region. To our knowledge, this study is the first to demonstrate that unproductive cough and Forced Expiration result in movement of secretions proximally from all regions of the lung in patients with airways obstruction.
M Van Hengstum - One of the best experts on this subject based on the ideXlab platform.
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effect of positive expiratory pressure mask physiotherapy pep versus Forced Expiration technique fet pd on regional lung clearance in chronic bronchitics
European Respiratory Journal, 1991Co-Authors: M Van Hengstum, J Festen, C Beurskens, M Hankel, F Beekman, F.h.m. CorstensAbstract:On theoretical grounds it is assumed that positive expiratory pressure mask physiotherapy (PEP) as a means of promoting mucus clearance is especially effective in the more distal airways. In a randomized cross-over trial including a control measurement the effect of PEP and of the Forced Expiration technique combined with postural drainage (FET/PD) on regional lung clearance was evaluated in seven patients with chronic bronchitis and abundant sputum production (mean 32 g.day-1). PEP consisted of positive expiratory pressure mask breathing interspersed with breathing exercises, Forced Expiration manoeuvres (huffing) and, if necessary, coughing. FET consisted of breathing exercises, huffing and also, if necessary, coughing. FET was combined with PD. Following inhalation of a radio-aerosol regional lung clearance was estimated by means of gamma camera imaging. The results after PEP appeared to be not significantly different from control. The mean clearance in all three lung zones (peripheral, intermediate and inner) was largest after FET/PD as compared with PEP and control. Statistical significance (p less than 0.02) was reached only for clearance in the inner region. It is concluded that PEP has no demonstrable effect on regional lung clearance in these patients.
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Effect of positive expiratory pressure mask physiotherapy (PEP) versus Forced Expiration technique (FET/PD) on regional lung clearance in chronic bronchitics.
The European respiratory journal, 1991Co-Authors: M Van Hengstum, J Festen, C Beurskens, M Hankel, F Beekman, F.h.m. CorstensAbstract:On theoretical grounds it is assumed that positive expiratory pressure mask physiotherapy (PEP) as a means of promoting mucus clearance is especially effective in the more distal airways. In a randomized cross-over trial including a control measurement the effect of PEP and of the Forced Expiration technique combined with postural drainage (FET/PD) on regional lung clearance was evaluated in seven patients with chronic bronchitis and abundant sputum production (mean 32 g.day-1). PEP consisted of positive expiratory pressure mask breathing interspersed with breathing exercises, Forced Expiration manoeuvres (huffing) and, if necessary, coughing. FET consisted of breathing exercises, huffing and also, if necessary, coughing. FET was combined with PD. Following inhalation of a radio-aerosol regional lung clearance was estimated by means of gamma camera imaging. The results after PEP appeared to be not significantly different from control. The mean clearance in all three lung zones (peripheral, intermediate and inner) was largest after FET/PD as compared with PEP and control. Statistical significance (p less than 0.02) was reached only for clearance in the inner region. It is concluded that PEP has no demonstrable effect on regional lung clearance in these patients.
A. Hasani - One of the best experts on this subject based on the ideXlab platform.
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Regional lung clearance during cough and Forced Expiration technique (FET): effects of flow and viscoelasticity.
Thorax, 1994Co-Authors: A. Hasani, Demetri Pavia, John E. Agnew, Stewart W. ClarkeAbstract:BACKGROUND--In vitro studies have suggested that both the viscoelastic properties of lung secretions and the peak flow attained during simulated cough influence clearance. This study examines the possible association of the viscoelastic properties of sputum and maximum expiratory flow with measured effectiveness of mucus clearance induced by instructed cough and by Forced Expiration technique (FET) in patients with airways obstruction. METHODS--Nineteen patients (11 men and eight women) of mean (SE) age, % predicted FEV1, and daily sputum wet weight of 64 (2) years, 52 (6)%, and 37.5 (7.9) g respectively participated in the study. Mucus movement from proximal and peripheral lung regions was measured by an objective non-invasive radioaerosol technique. Each patient underwent three assessments: control, cough, and FET. During cough and FET, maximum expiratory flow was measured at the mouth level. Apparent viscosity and elasticity of the expectorated sputum samples were measured with a viscometer. RESULTS--Compared with the control run (mean (SE) clearance: 16 (3)%) there was an increase in clearance from the whole lung during cough (44 (5)%) and FET (42 (5)%), and also an enhanced clearance of inhaled, deposited radioaerosol from the trachea, inner and intermediate regions of the lungs, but not from the outer region. There were, however, no differences in regional clearance between cough and FET. Neither regional nor total clearance correlated with maximum expiratory flow, apparent viscosity, elasticity, or daily sputum wet weight. CONCLUSIONS--These results confirm that cough and FET both promote effective clearance but suggest that, unlike in vitro studies, sputum production and viscoelasticity, as well as maximum expiratory flow, provide no guide to clearance efficacy in humans.
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Regional Mucus Transport Following Unproductive Cough and Forced Expiration Technique in Patients With Airways Obstruction
Chest, 1994Co-Authors: A. Hasani, Demetri Pavia, John E. Agnew, Stewart W. ClarkeAbstract:It has previously been shown that unproductive coughing in both healthy subjects and patients with airways obstruction is not effective in clearing lung secretions. This study investigates the regional mucus transport in a group of subjects with airways obstruction who failed to expectorate following instructed cough and Forced Expiration technique. Fourteen patients (mean±SEM age: 68±2 years) with airways obstruction (mean±SEM percent predicted FEV 1 : 54±5; daily wet weight sputum: 9.1±2.0 g) took part in the study which was a randomized, three-way crossover within-patient design. Each patient underwent three treatment maneuvers: control, cough (30 coughs over a 10-min period), and Forced Expiration (30 Forced Expirations over a 10-min period). An objective radioaerosol technique was used to monitor regional mucus movement within the lungs of the patients. The lungs were divided arbitrarily into four regions of interest: tracheal, inner, intermediate, and outer. Peak expiratory flow rate during cough and Forced Expiration was measured at the mouth. There was no correlation between the radioaerosol clearance from all regions and (1) mean peak flow during cough and Forced Expiration, and (2) mean 24-h sputum production prior to the study day. There were no differences in regional radioaerosol clearance between cough and Forced Expiration. However, both cough and Forced Expiration resulted in significant clearance compared with control for all regions with the exception of the Forced Expiration in the outer region. To our knowledge, this study is the first to demonstrate that unproductive cough and Forced Expiration result in movement of secretions proximally from all regions of the lung in patients with airways obstruction.
C Beurskens - One of the best experts on this subject based on the ideXlab platform.
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effect of positive expiratory pressure mask physiotherapy pep versus Forced Expiration technique fet pd on regional lung clearance in chronic bronchitics
European Respiratory Journal, 1991Co-Authors: M Van Hengstum, J Festen, C Beurskens, M Hankel, F Beekman, F.h.m. CorstensAbstract:On theoretical grounds it is assumed that positive expiratory pressure mask physiotherapy (PEP) as a means of promoting mucus clearance is especially effective in the more distal airways. In a randomized cross-over trial including a control measurement the effect of PEP and of the Forced Expiration technique combined with postural drainage (FET/PD) on regional lung clearance was evaluated in seven patients with chronic bronchitis and abundant sputum production (mean 32 g.day-1). PEP consisted of positive expiratory pressure mask breathing interspersed with breathing exercises, Forced Expiration manoeuvres (huffing) and, if necessary, coughing. FET consisted of breathing exercises, huffing and also, if necessary, coughing. FET was combined with PD. Following inhalation of a radio-aerosol regional lung clearance was estimated by means of gamma camera imaging. The results after PEP appeared to be not significantly different from control. The mean clearance in all three lung zones (peripheral, intermediate and inner) was largest after FET/PD as compared with PEP and control. Statistical significance (p less than 0.02) was reached only for clearance in the inner region. It is concluded that PEP has no demonstrable effect on regional lung clearance in these patients.
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Effect of positive expiratory pressure mask physiotherapy (PEP) versus Forced Expiration technique (FET/PD) on regional lung clearance in chronic bronchitics.
The European respiratory journal, 1991Co-Authors: M Van Hengstum, J Festen, C Beurskens, M Hankel, F Beekman, F.h.m. CorstensAbstract:On theoretical grounds it is assumed that positive expiratory pressure mask physiotherapy (PEP) as a means of promoting mucus clearance is especially effective in the more distal airways. In a randomized cross-over trial including a control measurement the effect of PEP and of the Forced Expiration technique combined with postural drainage (FET/PD) on regional lung clearance was evaluated in seven patients with chronic bronchitis and abundant sputum production (mean 32 g.day-1). PEP consisted of positive expiratory pressure mask breathing interspersed with breathing exercises, Forced Expiration manoeuvres (huffing) and, if necessary, coughing. FET consisted of breathing exercises, huffing and also, if necessary, coughing. FET was combined with PD. Following inhalation of a radio-aerosol regional lung clearance was estimated by means of gamma camera imaging. The results after PEP appeared to be not significantly different from control. The mean clearance in all three lung zones (peripheral, intermediate and inner) was largest after FET/PD as compared with PEP and control. Statistical significance (p less than 0.02) was reached only for clearance in the inner region. It is concluded that PEP has no demonstrable effect on regional lung clearance in these patients.