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Respir Med. 2011 Sep;105(9):1316-21. doi: 10.1016/j.rmed.2011.04.017.

The influence of Flutter®VRP1 components on mucus transport of patients with bronchiectasis.

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University of São Paulo, Ribeirão Preto, São Paulo, Brazil.



The Flutter(®)VRP1 combines high frequency oscillation and positive expiratory pressure (PEP).


To separately evaluate the effect of the Flutter(®)VRP1 components (high frequency oscillation and PEP) on mucus transportability in patients with bronchiectasis.


Eighteen patients with bronchiectasis received sessions with the Flutter(®)VRP1 or PEP for 30 min daily in a randomized, crossover study. The treatment duration was four weeks with one of the therapies, one week of a "wash-out" period and followed by four more weeks with the other treatment. Weekly secretion samples were collected and evaluated for mucociliary relative transport velocity (RTV), displacement in a simulated cough machine (SCM) and contact angle measurement (CAM). For the proposed comparisons, a linear regression model was used with mixed effects with a significance level of 5%.


The Flutter(®)VRP1 treatment resulted in greater displacement in SCM and lower CAM when comparing results from the first (9.6 ± 3.4 cm and 29.4 ± 5.7°, respectively) and fourth weeks of treatment (12.44 ± 10.5 cm and 23.28 ± 6.2°, respectively; p < 0.05). There was no significant difference in the RTV between the treatment weeks for either the Flutter(®)VRP1 or PEP.


The use of the Flutter(®)VRP1 for four weeks is capable of altering the respiratory secretion transport properties, and this alteration is related to the high frequency oscillation component.

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