Effect of slow expiration with glottis opened in lateral posture (ELTGOL) on mucus clearance in stable patients with chronic bronchitis

Abstract

BACKGROUND: Slow expiration with glottis opened in lateral posture (ELTGOL, l'expiration lente totale glotte ouverte en infralatéral) has been used in clinical practice to improve mucus clearance from peripheral airways. The purpose of this crossover study was to evaluate the effect of ELTGOL on mucus clearance of right and left lungs, especially of peripheral lung areas, in stable patients with chronic bronchitis. METHODS: Twelve 45-75-year-old patients with chronic bronchitis were studied (10 of whom had mild to moderate COPD according to the Global Initiative for Chronic Obstructive Lung Disease guidelines). Control and ELTGOL interventions were performed on a randomized allocation of subjects. Mucus clearance was measured through 6 posterior scintigraphy images taken with the patient in the right lateral decubitus position 20 (T1), 40 (T2), 60 (T3), 80 (T4), and 120 (T5) min after baseline image (T0). In the control intervention only ventilatory scintigraphy measurements were performed. During ELTGOL the technique was performed after the baseline image (T0). RESULTS: Significant increases in mucus clearance from the peripheral area were found only in the right lung, and were observed at all times during ELTGOL (P