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To answer this question, we used the nitrogen multiple\u2010breath washout (N<jats:sub>2<\/jats:sub>MBW) test to measure diffusion\u2010convection\u2010dependent inhomogeneity arising within the intracinar compartment (S<jats:sub>acin<\/jats:sub>*VT).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>For this randomized, sham\u2010controlled crossover trial, two N<jats:sub>2<\/jats:sub>MBW tests were performed near the hospital discharge date: one before and the other after PEP mask therapy (1\u2009min of breathing through a flow\u2010dependent PEP device attached to a face mask, followed by three huffs and one cough repeated 10 times) by either a standard (10\u201315\u2009cmH<jats:sub>2<\/jats:sub>0) or a sham (&lt;5\u2009cmH<jats:sub>2<\/jats:sub>0) procedure on two consecutive mornings. Deception entailed misinforming the subjects about the nature of the study; also the N<jats:sub>2<\/jats:sub>MBW operators were blinded to treatment allocation. Study outcomes were assessed with mixed\u2010effect models.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The study sample was 19 cwCF (ten girls), aged 11.4 (2.7) years. The adjusted S<jats:sub>acin<\/jats:sub>*VT mean difference between the standard and the sham procedure was \u22120.015 (90% confidence interval [CI]: \u2212\u221e to 0.025)\u2009L<jats:sup>\u22121<\/jats:sup>. There was no statistically significant difference in S<jats:sub>cond<\/jats:sub>*VT and lung clearance index between the two procedures: \u22120.005 (95% CI: \u22120.019 to 0.01)\u2009L<jats:sup>\u22121<\/jats:sup> and 0.49 (95% CI: \u22120.05 to 1.03) turnovers, respectively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Our findings do not support evidence for an immediate effect of PEP mask physiotherapy on S<jats:sub>acin<\/jats:sub>*VT with pressure range 10\u201315 cmH<jats:sub>2<\/jats:sub>0. Measurement with the N<jats:sub>2<\/jats:sub>MBW and the crossover design were found to be time\u2010consuming and unsuitable for a short\u2010term study of airway clearance techniques.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ppul.26915","type":"journal-article","created":{"date-parts":[[2024,2,16]],"date-time":"2024-02-16T10:45:55Z","timestamp":1708080355000},"page":"1354-1363","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Short\u2010term effects of positive expiratory pressure mask on ventilation inhomogeneity in children with cystic fibrosis: A randomized, sham\u2010controlled crossover study"],"prefix":"10.1002","volume":"59","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6225-2989","authenticated-orcid":false,"given":"Simone","family":"Gambazza","sequence":"first","affiliation":[{"name":"Healthcare Professions Department Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico Milan 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