Airway Clearance with Expiratory Flow Accelerator Technology: Effectiveness of the “Free Aspire” Device in Patients with Severe COPD

Abstract

OBJECTIVES: Chronic obstructive pulmonary disease (COPD) is associated with a higher risk of pulmonary infections. This risk not onlynegatively affects patients’ quality of life but also increases social and health costs. Hence, there is a need for an effective rehabilitativetreatment including airway clearance. The aim of this pilot study was to evaluate the efficacy of a new tool for bronchial clearance basedon expiratory flow accelerator (EFA) technology compared with positive expiratory pressure (PEP) treatment.MATERIALS AND METHODS: Twenty stable patients with COPD, Global Initiative for Chronic Obstructive Lung Disease 3–4 stage, wereenrolled and allocated to treatment with EFA or Bubble-PEP (BP) for 20 days during a pulmonary rehabilitation program. At baseline andthe end of treatment, the following parameters were measured: arterial blood gases (ABG); respiratory function, including peak coughexpiratory flow (PCEF), maximal inspiratory pressure (MIP), and maximal expiratory pressure exercise capacity using the 6-minute walktest (6MWT), dyspnea using the Medical Research Council scale, and quality of life using the St. George’s Respiratory Questionnaire.RESULTS: Expiratory flow accelerator showed a significant pre- and post-improvement in ABG and a significantly greater improvementthan BP in PCEF, MIP, and 6MWT post-treatment.CONCLUSION: Expiratory flow accelerator is a valid device compared with BP as an adjunctive therapy for the treatment of patientswith severe COPD.