Late Breaking Abstract - Short-term effects of a novel bronchial drainage device in Cystic Fibrosis patients

In airways of Cystic fibrosis (CF) patients, impaired airway mucociliary clearance and mucus accumulation due to CFTR defects contribute to inflammation, progressive structural lung damage, and decline of lung function. Physiotherapy is essential to promote mucus mobilization and removal. For this purpose, a novel bronchial drainage device (BDD) (Simeox, PhysioAssist, France) using an oscillatory technology had been recently developed. In this study, we investigated BDD short-term effects in patients with CF. We hypothesized that the novel BDD improves lung function and diaphragm mobility and affects sputum properties. 21 adult patients with stable CF lung disease participated in two physiotherapy sessions using the novel BDD. We assessed lung function parameters using spirometry and diaphragm mobility using m-mode ultrasound analysis before and after both study sessions. Spontaneous sputum samples were collected before and after using the BDD and analyzed for viscosity and DNA concentrations. Lung function parameters (FEV1, FVC, MEF25/50/75) were not affected by the use of the BDD. Ultrasound analysis of diaphragm mobility revealed a significant increase of maximum diaphragm excursion from 2.27 ±0.12cm (mean ± SEM) to 2.47 ± 0.13cm upon the intervention (p=0.02). Mucus analysis demonstrated higher viscosity and higher DNA concentrations im samples collected after using the BDD compared to before. Pearson correlation analysis showed significant correlation between changes of mucus viscosity and DNA levels in respective mucus samples (p=0.007). Our results demonstrate that the novel BDD improves diaphragm mobility and promotes the expectoration of highly viscous mucus in patients with CF.