HUMIDIFICATION AS AN ADJUNCT TO CHEST PHYSIOTHERAPY IN AIDING TRACHEOBRONCHIAL CLEARANCE IN PATIENTS WITH BRONCHIECTASIS

Humidification of inspired air or oxygen is frequently utilized by respiratory physiotherapists to relieve sputumretention. Cold water, jet nebulizing humidifiers are in widespread use but there has been no previous attempt to investigate the efficacy of this treatment. We have performed a single-blind, cross-over study to quantify the effect of humidification as an adjunct to chest physiotherapy. Seven patients with bronchiectasis completed the trial, with a mean (range) age of 51 years (41–64 years) and mean (range) percent of predicted FEV, of 46% (29–76%). On 2 days, separated by 1 week, subjects were randomly allocated to humidification or no humidification as a precursor to an optimal chest physiotherapy regimen. A radio-aerosol of human serum albumin millimicrospheres labelled with 99mTechnetium was used to measure sputum clearance by serial gamma camera images. Serial measurements of sputum weight and FEV1 were also recorded. Humidification (30 min) was followed by postural drainage (20 min) with the subject using the forced expiration technique to assist clearance. When humidification was combined with physiotherapy there was a significant increase in total wet weight of sputum (P<0.05) with a median (range) increase of 6 g (−9–15.5 g); and a significant increase in total radiolabel clearance (P<0.05) with a median (range) increase of 8–7% (1–13%), compared to physiotherapy alone. This study demonstrates that the use of cold water, jet nebulizing humidifiers significantly increases tracheo-bronchial clearance above that of an optimal physiotherapy regimen alone in bronchiectasis. We would suggest that this has important clinicial implications in the management of sputum retention in patients with hypersecretory lung disease. © 1992, Baillière Tindall All rights reserved. All rights reserved.