Feasibility and safety evaluation of Simeox airway clearance technique (ACT) in patients with bronchiectasis

<b>Introduction:</b> ACTs improve bronchial drainage in various obstructive lung diseases with sticky and viscid mucus. Patients with bronchiectasis are a good indication for airway clearance therapy but new techniques required to be evaluated. <b>Aim:</b> Goal of this pilot study was to assess feasibility and safety of an innovative ACT compared to manual chest physiotherapy (CPT) for airway clearance management of hospitalized patients suffering from bronchiectasis. <b>Methods:</b> Patients with bronchiectasis were randomized to CPT or a new device (Simeox, Physio-Assist) facilitating mucus clearance by generating successive and intermittent intrapulmonary negative air pressure during relaxed exhalation, and treated for 5 days (2 sessions of 20 min each per day). Pulmonary function test, chest expansion, mucus collection and SpO2 were performed before and after procedure. <b>Results:</b> 12 patients randomized 1:1 (7 CF, 3 COPD, 2 IPF). After 5 days of therapy, there was a similar trend in FEV1% and total sputum production improvement between Simeox (+2.5%; +143ml) and CPT (+1.5%; +30ml). Chest expansion and SpO2 increased significantly to a similar extent in both groups. A longitudinal rise of Sp02 pre-therapy leading to less SpO2 fluctuations was observed during the 5 days in the device group only (R²=0.705; p = 0.002), suggesting a persistent effect of therapy. The device was well tolerated and no safety signal was detected. Patients appreciated the device and found it comfortable. <b>Conclusions:</b> This study showed non-inferiority of device procedure compared to CPT. Simeox ACT was considered safe and feasible for airway clearance management during hospitalization of different lung diseases with mucus retention