BOTTLE-BLOWING IN HOSPITAL-TREATED PATIENTS WITH COMMUNITY-ACQUIRED PNEUMONIA

A study was carried out to determine whether bottle-blowing has any po sitive effects in patients with pneumonia. In a prospective open study 145 adults with untreated community-acquired pneumonia requiring hosp italization mere randomized to early mobilization (group A), to sit up and take 20 deep breaths on 10 occasions daily (group B), or to sit u p and to blow bubbles in a bottle containing 10 cm water through a pla stic tube 20 times on 10 occasions daily (group C). Peak expiratory fl ow (PEF) vital capacity (VC), forced expiratory volume in 1 sec (FEV(1 )) and serum concentration of C-reactive protein (CRP) mere determined on admission, and on days 4 and 42. Fever duration and hospital stay were recorded. In a subset of 16 patients, single breath diffusion cap acity of carbon monoxide was measured on 3 occasions. The patients in group A were hospitalized for a mean of 5.3 days, group B for 4.6 days and group C for 3.9 days. Treatment was a significant factor (p = 0.0 37) in a Cox regression model, with group C significantly better than group A (p = 0.01). The number of days with fever was 2.3, 1.7 and 1.6 in groups A, B and C respectively. These differences were not signifi cant (p = 0.28). No significant differences were found between the gro ups regarding CRP, PEF, VC, FEV(1), or diffusion capacity. Intensive b ottle-blowing shortens the hospital stay in patients with pneumonia. T he underlying mechanism is not clear.