The Science Journal of the American Association for Respiratory Care

2012 OPEN FORUM Abstracts

COMPARISON BETWEEN STANDARD AND EMPIRIC SPIROTIGER(R) SETUP IN PATIENTS WITH CYSTIC FIBROSIS.

Anna Brivio1,4, Clara Ceruti1,4, Giancarlo Piaggi2,4, Simone Gambazza3,4; 1IRCCS Fondazione Ca’Granda Ospedale Maggiore Policlinico, MILANO, Italy; 2Fondazione IRCCS S.Maugeri, Pavia, Italy; 3Azienda Ospedaliera Universitaria A.Meyer, Firenze, Italy; 4ARIR-Associazione Fisioterapisti Insufficienza Respiratoria, Milano, Italy

Background. Several studies have shown that improved respiratory muscles strength and better exercise capacity due to their training improve distance at the 6 minutes Walk Test, quality of life and reduce dyspnoea. Lately, it has been commercially available a new portable device, Spirotiger®, that trains respiratory muscles throughout isocapnic hyperpnea, that improves pulmonary functions as reported with athletes. Now, its use has been thought suitable also for patients suffering from respiratory disease, such as Cystic Fibrosis (CF). So far, the device setup has been prompted on parameters derived by healthy subjects and it might not be appropriate for patients with CF. Aim.To evaluate differences in the setup between derived formula and patients measured parameters. Methods. 47 CF patients (46.8% men) in clinically stable conditions were enrolled. FEV1 (Forced Expiratory Volume in the 1st sec.), FVC (Forced Vital Capacity), RR (Respiratory Rate), MVV (Maximal Voluntary Ventilation) were collected according to ATS/ERS procedure. RR, MVV, RMV (Respiratory Minute Volume) and the required bag volume have been compared with standard and empiric formulas. Sample was described and then processed using Wilcoxon matched-pairs signed-ranks test with significance set at 5%. Results. Patients age ranged from 18 up to 45 yrs (25±37.47) with mean BMI of 21.20±2.65 Kg/m2. Mean predicted %FEV1 was 73.53±24.9. Through standard formulas as provided by the manufacturer, a mean MVV of 138.49±410.99 l/min, a mean RMV of 83.09±6.59 l/min, a mean bag volume of 2.36±0,.26 l and a mean RR of 27.80 ± 9.75 were found. Through the empirical setup, mean MVV was 106.04±43.88 l/min, mean RMV was 63.62±26.33 l/min, mean bag volume 1.77±0.55 and mean RR 28.04±9.63. Difference of means between standard and empiric formulas for RR (p=0.83) was not statistically significant, while for MVV (p < 0.0001), RMV (p < 0.0001) and the bag volume (p < 0.0001) means were statistically different. Mean differences were not closed to zero for RMV and MVV, respectively -19.46 l/min and -32.44 l/min thus arguing an overall distortion that might be have clinical impact. Conclusions. Given such differences, suitability of standard and empirical formulas need to be tested not only on patients with CF but also with other pulmonary disease. In order to assess whether Spirotiger® could have some effects on respiratory muscle training, further studies are urgently required taking into account such variability. Sponsored Research - None