Role of Flutter Valve in Management and Clearance of Secretion in Patients with Bronchiectasis

Background: There is little scientific evidence supporting the use of flutter valve in the management of bronchiectasis. Aim of the Work: To evaluate the flutter valve in the clearance of secretion associated with bronchiectasis. Subjects: 30 patients with bronchiectasis with acute exacerbation selected from the Department of the Chest Diseases, Bab El-Sha aria Al-Azhar University Hospital. This study was performed during the period from September 2012 to July 2015. They were divided into two groups: Group (A): Fifteen patients received medical treatment and traditional chest physiotherapy (postural drainage, percussion) and flutter valve twice daily from first day of admission, Group (B): Fifteen patients received medical treatment and traditional chest physiotherapy and sham flutter. Methods: All patients underwent the following: Full history taking, X-ray chest, high resolution C-T chest for diagnosis then pulmonary function tests, 6 minute walking test and arterial blood gases at first day, after one week and after two weeks of treatment and the amount of sputum was calculated per 24 hours. Results: There was statistically improvement in the following; forced expiratory volume in first second after 2 weeks in both groups p 0.01, and partial pressure of oxygen in arterial blood in both groups after 1, 2 weeks p 0.01 and improvement after two weeks in Group A than Group B with p-value 0.040 and decrease in level of partial pressure of carbon dioxide in the arterial blood in both groups p 0.01 and decrease level in Group A than Group B after 1, 2 weeks p-value 0.009, p-value 0.001 and improvement in 6 minute walking test in both groups (p 0.05) and no statistically difference between two group after 1, 2 weeks (p 0.05). reduction to 80% to the amount on first day occur in 10.8±0.94 day in Group A and in 15.73±2.34 day Group B with p-value 0.001. Hospital stay was 15±1 day in Group A and was 20±3.21 day in Group B with statistically significant difference for less duration in hospital stay in Group A using flutter valve with p-value 0.001. Conclusions: Flutter improves pulmonary function and 6 minute walking test, clearance of secrtion in bronchiectasis, and should be included among the principal options in chest physiotherapy.