Cargando…
Bronchoscopic airway clearance therapy for acute exacerbations of bronchiectasis
BACKGROUND: Persistent cough and large amounts of purulent sputum affects many bronchiectasis patients. No studies have evaluated the efficacy and safety of bronchoscopic airway clearance therapy and bronchoalveolar lavage (B-ACT) for non-cystic fibrosis bronchiectasis patients with acute exacerbati...
Autores principales: | , , , , , , , , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Elsevier
2021
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8452777/ https://www.ncbi.nlm.nih.gov/pubmed/34537448 http://dx.doi.org/10.1016/j.ebiom.2021.103587 |
_version_ | 1784570140002615296 |
---|---|
author | Liu, Yang Lu, Hai-Wen Gu, Shu-Yi Wang, Wen-Wen Ge, Juan Jie, Zhi-Jun Jia, Jin-Guang Gao, Zhi-Ting Li, Jun Shi, Jing-Yun Liang, Shuo Cheng, Ke-Bing Bai, Jiu-Wu Qu, Jie-Ming Xu, Jin-Fu |
author_facet | Liu, Yang Lu, Hai-Wen Gu, Shu-Yi Wang, Wen-Wen Ge, Juan Jie, Zhi-Jun Jia, Jin-Guang Gao, Zhi-Ting Li, Jun Shi, Jing-Yun Liang, Shuo Cheng, Ke-Bing Bai, Jiu-Wu Qu, Jie-Ming Xu, Jin-Fu |
author_sort | Liu, Yang |
collection | PubMed |
description | BACKGROUND: Persistent cough and large amounts of purulent sputum affects many bronchiectasis patients. No studies have evaluated the efficacy and safety of bronchoscopic airway clearance therapy and bronchoalveolar lavage (B-ACT) for non-cystic fibrosis bronchiectasis patients with acute exacerbation. METHODS: A randomised controlled trial was conducted to explore the efficacy and safety of B-ACT among 189 bronchiectasis inpatients from February 1, 2018 to February 28, 2019. The primary outcome was the time to first acute exacerbation. Secondary outcomes included changes of health-related scores, length of hospital stay, hospitalization expenses and incidences of adverse events. FINDINGS: B-ACT therapy significantly prolonged the median days to first acute exacerbation when compared with control group (198 vs 168 days, HR 0·555 (0·322-0·958), p=0·012; effect size(r)= 0·94). Further analysis showed that B-ACT therapy was more beneficial for these patients with severe disease and greater symptoms. COPD Assessment Test (CAT) scores improved significantly on the third day (5·45 vs 4·85, 0·60 (0·09-1·11), p=0·023), and Leicester Cough Questionnaire (LCQ) scores improved obviously on the third and seventh days (1·53 vs 1·23, 0·30 (0·05-0·55), p=0·044; 1·66 vs 1·32, 0·34 (0·08-0·60), p=0·022; respectively) after B-ACT therapy. Adverse events associated with B-ACT were mostly transient and mild. Differences of the lengths of hospital stay and hospitalization expenses in both group was not significant. INTERPRETATION: B-ACT therapy significantly prolonged the time to first acute exacerbation after discharge, highlighting the importance of B-ACT therapy focused on symptom improvements in preventing exacerbation. FUNDING: National Natural Science Foundation of China. TRIAL REGISTRY: ClinicalTrials.gov; No.:NCT03643302; URL: www.clinicaltrials.gov. |
format | Online Article Text |
id | pubmed-8452777 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Elsevier |
record_format | MEDLINE/PubMed |
spelling | pubmed-84527772021-09-27 Bronchoscopic airway clearance therapy for acute exacerbations of bronchiectasis Liu, Yang Lu, Hai-Wen Gu, Shu-Yi Wang, Wen-Wen Ge, Juan Jie, Zhi-Jun Jia, Jin-Guang Gao, Zhi-Ting Li, Jun Shi, Jing-Yun Liang, Shuo Cheng, Ke-Bing Bai, Jiu-Wu Qu, Jie-Ming Xu, Jin-Fu EBioMedicine Research Paper BACKGROUND: Persistent cough and large amounts of purulent sputum affects many bronchiectasis patients. No studies have evaluated the efficacy and safety of bronchoscopic airway clearance therapy and bronchoalveolar lavage (B-ACT) for non-cystic fibrosis bronchiectasis patients with acute exacerbation. METHODS: A randomised controlled trial was conducted to explore the efficacy and safety of B-ACT among 189 bronchiectasis inpatients from February 1, 2018 to February 28, 2019. The primary outcome was the time to first acute exacerbation. Secondary outcomes included changes of health-related scores, length of hospital stay, hospitalization expenses and incidences of adverse events. FINDINGS: B-ACT therapy significantly prolonged the median days to first acute exacerbation when compared with control group (198 vs 168 days, HR 0·555 (0·322-0·958), p=0·012; effect size(r)= 0·94). Further analysis showed that B-ACT therapy was more beneficial for these patients with severe disease and greater symptoms. COPD Assessment Test (CAT) scores improved significantly on the third day (5·45 vs 4·85, 0·60 (0·09-1·11), p=0·023), and Leicester Cough Questionnaire (LCQ) scores improved obviously on the third and seventh days (1·53 vs 1·23, 0·30 (0·05-0·55), p=0·044; 1·66 vs 1·32, 0·34 (0·08-0·60), p=0·022; respectively) after B-ACT therapy. Adverse events associated with B-ACT were mostly transient and mild. Differences of the lengths of hospital stay and hospitalization expenses in both group was not significant. INTERPRETATION: B-ACT therapy significantly prolonged the time to first acute exacerbation after discharge, highlighting the importance of B-ACT therapy focused on symptom improvements in preventing exacerbation. FUNDING: National Natural Science Foundation of China. TRIAL REGISTRY: ClinicalTrials.gov; No.:NCT03643302; URL: www.clinicaltrials.gov. Elsevier 2021-09-16 /pmc/articles/PMC8452777/ /pubmed/34537448 http://dx.doi.org/10.1016/j.ebiom.2021.103587 Text en © 2021 The Author(s) https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). |
spellingShingle | Research Paper Liu, Yang Lu, Hai-Wen Gu, Shu-Yi Wang, Wen-Wen Ge, Juan Jie, Zhi-Jun Jia, Jin-Guang Gao, Zhi-Ting Li, Jun Shi, Jing-Yun Liang, Shuo Cheng, Ke-Bing Bai, Jiu-Wu Qu, Jie-Ming Xu, Jin-Fu Bronchoscopic airway clearance therapy for acute exacerbations of bronchiectasis |
title | Bronchoscopic airway clearance therapy for acute exacerbations of bronchiectasis |
title_full | Bronchoscopic airway clearance therapy for acute exacerbations of bronchiectasis |
title_fullStr | Bronchoscopic airway clearance therapy for acute exacerbations of bronchiectasis |
title_full_unstemmed | Bronchoscopic airway clearance therapy for acute exacerbations of bronchiectasis |
title_short | Bronchoscopic airway clearance therapy for acute exacerbations of bronchiectasis |
title_sort | bronchoscopic airway clearance therapy for acute exacerbations of bronchiectasis |
topic | Research Paper |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8452777/ https://www.ncbi.nlm.nih.gov/pubmed/34537448 http://dx.doi.org/10.1016/j.ebiom.2021.103587 |
work_keys_str_mv | AT liuyang bronchoscopicairwayclearancetherapyforacuteexacerbationsofbronchiectasis AT luhaiwen bronchoscopicairwayclearancetherapyforacuteexacerbationsofbronchiectasis AT gushuyi bronchoscopicairwayclearancetherapyforacuteexacerbationsofbronchiectasis AT wangwenwen bronchoscopicairwayclearancetherapyforacuteexacerbationsofbronchiectasis AT gejuan bronchoscopicairwayclearancetherapyforacuteexacerbationsofbronchiectasis AT jiezhijun bronchoscopicairwayclearancetherapyforacuteexacerbationsofbronchiectasis AT jiajinguang bronchoscopicairwayclearancetherapyforacuteexacerbationsofbronchiectasis AT gaozhiting bronchoscopicairwayclearancetherapyforacuteexacerbationsofbronchiectasis AT lijun bronchoscopicairwayclearancetherapyforacuteexacerbationsofbronchiectasis AT shijingyun bronchoscopicairwayclearancetherapyforacuteexacerbationsofbronchiectasis AT liangshuo bronchoscopicairwayclearancetherapyforacuteexacerbationsofbronchiectasis AT chengkebing bronchoscopicairwayclearancetherapyforacuteexacerbationsofbronchiectasis AT baijiuwu bronchoscopicairwayclearancetherapyforacuteexacerbationsofbronchiectasis AT qujieming bronchoscopicairwayclearancetherapyforacuteexacerbationsofbronchiectasis AT xujinfu bronchoscopicairwayclearancetherapyforacuteexacerbationsofbronchiectasis |