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The effects of ELTGOL on mucociliary clearance in patients with COPD

^* Arnaldo Gavazza Filho Hospital, Ponte Nova, MG, Brazil ^# Federal University of Pernambuco, Recife, PE, Brazil ^¶ Federal University of Minas Gerais, Belo Horizonte, MG, Brazil

CORRESPONDENCE: Jocimar A. Martins, Arnaldo Gavazza Filho Hospital, Ponte Nova, MG, Brazil

Excessive tracheobronchial secretion is a common complication of chronic obstruction pulmonary disease (COPD) and its presence is associated with lower survival, greater hospitalization and death. Slow expiration with the glottis open in a lateral posture (ELTGOL) is a chest physiotherapy procedure for the removal of lung secretions. Studies which have assessed ELTGOL through pulmonary scintigraphy were not found [1]. The aim this study was to evaluate the effects of ELTGOL on the mucociliary clearance in patients with COPD.

Twelve patients with COPD aged 45 to 75 years were studied. After inhaling 20 mCi of 99mTc-DTPA [2], six posterior static scintigraphy images were taken in intervals of 0, 20, 40, 60, 80 and 120 minutes (figure 1).

View larger version (97K): [in this window] [in a new window]   FIGURE 1. Scintigraphy image.

 
The study was carried out in two stages (control and experimental) in a randomized order with a minimum interval of one week between the stages. In the experimental stage, ELTGOL was carried out after the first image. The right lung was studied, comparing the percentage of retention [3] of radioactive aerosol obtained during the control stage with the experimental condition, for each interval studied. The study was approved by the local ethics committee and all patients gave their written consent participate. The t test was used for data analysis with a significance level of <0.05.

As shown in figure 2, significant differences between groups were found between all time intervals.

View larger version (7K): [in this window] [in a new window]   FIGURE 2. Graphic of outcome of % retention of radioisotopes for control and experimental conditions. •: control; : ELTGOL. *: p<0.05.

 
The present results showed the ELTGOL significantly increased the mucociliary clearance suggesting that ELTGOL is an effective technique to improve secretion removal in patients with COPD.