RT Journal Article
SR Electronic
T1 Routine lung volume recruitment in boys with Duchenne muscular dystrophy: a randomised clinical trial
JF Thorax
JO Thorax
FD BMJ Publishing Group Ltd and British Thoracic Society
SP 805
OP 811
DO 10.1136/thoraxjnl-2021-218196
VO 77
IS 8
A1 Sherri L Katz
A1 Jean K Mah
A1 Hugh J McMillan
A1 Craig Campbell
A1 Vid Bijelić
A1 Nick Barrowman
A1 Franco Momoli
A1 Henrietta Blinder
A1 Shawn D Aaron
A1 Laura C McAdam
A1 The Thanh Diem Nguyen
A1 Mark Tarnopolsky
A1 David F Wensley
A1 David Zielinski
A1 Louise Rose
A1 Nicole Sheers
A1 David J Berlowitz
A1 Lisa Wolfe
A1 Doug McKim
YR 2022
UL http://thorax.bmj.com/content/77/8/805.abstract
AB Background Impaired cough results in airway secretion retention, atelectasis and pneumonia in individuals with Duchenne muscular dystrophy (DMD). Lung volume recruitment (LVR) stacks breaths to inflate the lungs to greater volumes than spontaneous effort. LVR is recommended in DMD clinical care guidelines but is not well studied. We aimed to determine whether twice-daily LVR, compared with standard of care alone, attenuates the decline in FVC at 2 years in boys with DMD.Methods In this multicentre, assessor-blinded, randomised controlled trial, boys with DMD, aged 6–16 years with FVC >30% predicted, were randomised to receive conventional treatment or conventional treatment plus manual LVR twice daily for 2 years. The primary outcome was FVC % predicted at 2 years, adjusted for baseline FVC % predicted, age and ambulatory status. Secondary outcomes included change in chest wall distensibility (maximal insufflation capacity minus FVC) and peak cough flow.Results Sixty-six boys (36 in LVR group, 30 in control) were evaluated (median age (IQR): 11.5 years (9.5–13.5), median baseline FVC (IQR): 85% predicted (73–96)). Adjusted mean difference in FVC between groups at 2 years was 1.9% predicted (95% CI −6.9% to 10.7%; p=0.68) in the direction of treatment benefit. We found no differences in secondary outcomes.Conclusion There was no difference in decline in FVC % predicted with use of twice-daily LVR for boys with DMD and relatively normal lung function. The burden associated with routine LVR may outweigh the benefit. Benefits of LVR to maintain lung health in boys with worse baseline lung function still need to be clarified.Trial registration number NCT01999075.No data are available.