{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,17]],"date-time":"2026-02-17T13:29:05Z","timestamp":1771334945349,"version":"3.50.1"},"reference-count":28,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2025,7,27]],"date-time":"2025-07-27T00:00:00Z","timestamp":1753574400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2025,7,27]],"date-time":"2025-07-27T00:00:00Z","timestamp":1753574400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100018548","name":"Curtin University","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100018548","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001170","name":"Cancer Council Western Australia","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001170","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000925","name":"National Health and Medical Research Council","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000925","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Respirology"],"published-print":{"date-parts":[[2025,11]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and Objective<\/jats:title>\n                    <jats:p>During exacerbations, when symptom and treatment burden are increased, individuals with cystic fibrosis (CF) are likely to prefer airway clearance techniques (ACTs) that require minimal effort. Therefore, in adults with CF who were hospitalised with an exacerbation, we sought to compare the effect of the MetaNeb with usual ACTs on respiratory function and expectorated sputum.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This was a non\u2010blinded randomised controlled trial where adults hospitalised with a CF exacerbation were allocated to an experimental intervention (EIx; MetaNeb) or a control intervention (CIx; their usual ACT). Both groups underwent twice\u2010daily supervised airway clearance sessions, over an intervention period that ranged from 5 to 7\u2009days during their hospitalisation. The primary outcome was ventilation inhomogeneity measured via lung clearance index (LCI) using the multiple breath washout technique. Secondary outcomes included adverse events, respiratory mechanics, forced expiratory volumes, sputum inflammatory markers, wellness, expectorated sputum, symptoms, participant satisfaction, and huff and cough counts.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Thirty participants were randomised (EIx group\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200914; CIx group\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200916). On completion of the intervention period, there was a greater improvement in LCI following the EIx than CIx (mean difference \u22120.84\u2009units [\u22121.66 to \u22120.02], as well as some measures of respiratory mechanics. There were no between\u2010group differences for the other secondary outcomes.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In adults with CF who were hospitalised with an exacerbation, twice daily MetaNeb produced greater improvements in ventilation inhomogeneity compared to twice daily usual ACTs. There were no between\u2010group differences shown for the other outcomes, including respiratory symptoms.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial Registration<\/jats:title>\n                    <jats:p>Australian New Zealand Clinical Trials Registry (ACTRN12619001681145)<\/jats:p>\n                    <jats:p>\n                      <jats:boxed-text content-type=\"graphic\" position=\"anchor\">\n                        <jats:graphic xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" mimetype=\"image\/png\" position=\"anchor\" specific-use=\"enlarged-web-image\" xlink:href=\"graphic\/resp70092-gra-0001-m.png\">\n                          <jats:alt-text>image<\/jats:alt-text>\n                        <\/jats:graphic>\n                      <\/jats:boxed-text>\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/resp.70092","type":"journal-article","created":{"date-parts":[[2025,7,28]],"date-time":"2025-07-28T01:23:08Z","timestamp":1753665788000},"page":"1046-1055","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["<scp>MetaNeb<\/scp>\n                    Versus Usual Care During Exacerbations of Cystic Fibrosis: An\n                    <scp>RCT<\/scp>"],"prefix":"10.1111","volume":"30","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7270-7804","authenticated-orcid":false,"given":"Naomi","family":"Chapman","sequence":"first","affiliation":[{"name":"Curtin School of Allied Health Faculty of Health Sciences, Curtin University  Perth Western Australia Australia"},{"name":"Physiotherapy Department Sir Charles Gairdner Hospital  Perth Western Australia Australia"},{"name":"Institute for Respiratory Health  Perth Western Australia Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vinicius","family":"Cavalheri","sequence":"additional","affiliation":[{"name":"Curtin School of Allied Health Faculty of Health Sciences, Curtin University  Perth Western Australia Australia"},{"name":"Institute for Respiratory Health  Perth Western Australia Australia"},{"name":"Allied Health, South Metropolitan Health Service  Murdoch Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elizabeth F.","family":"Smith","sequence":"additional","affiliation":[{"name":"Curtin School of Allied Health Faculty of Health Sciences, Curtin University  Perth Western Australia Australia"},{"name":"Wal\u2010Yan Respiratory Research Centre Telethon Kids Institute, Perth Children's Hospital  Perth Western Australia Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jamie","family":"Wood","sequence":"additional","affiliation":[{"name":"Abilities Research Center, Department of Rehabilitation and Human Performance Icahn School of Medicine at Mount Sinai  New York New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Luke W.","family":"Garratt","sequence":"additional","affiliation":[{"name":"Wal\u2010Yan Respiratory Research Centre Telethon Kids Institute, Perth Children's Hospital  Perth Western Australia Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7480-4835","authenticated-orcid":false,"given":"Siobhain","family":"Mulrennan","sequence":"additional","affiliation":[{"name":"Institute for Respiratory Health  Perth Western Australia Australia"},{"name":"Department of Respiratory Medicine Sir Charles Gairdner Hospital  Perth Western Australia Australia"},{"name":"Faculty of Health and Medical Sciences The University of Western Australia  Perth Western Australia Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anne","family":"Smith","sequence":"additional","affiliation":[{"name":"Curtin School of Allied Health Faculty of Health Sciences, Curtin University  Perth Western Australia Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anna S.","family":"Tai","sequence":"additional","affiliation":[{"name":"Institute for Respiratory Health  Perth Western Australia Australia"},{"name":"Department of Respiratory Medicine Sir Charles Gairdner Hospital  Perth Western Australia Australia"},{"name":"Faculty of Health and Medical Sciences The University of Western Australia  Perth Western Australia Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6082-6352","authenticated-orcid":false,"given":"Kylie","family":"Hill","sequence":"additional","affiliation":[{"name":"Curtin School of Allied Health Faculty of Health Sciences, Curtin University  Perth Western Australia Australia"},{"name":"Institute for Respiratory Health  Perth Western Australia Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,7,27]]},"reference":[{"key":"e_1_2_11_2_1","article-title":"Airway Clearance Techniques Compared to no Airway Clearance Techniques for Cystic Fibrosis","volume":"4","author":"Warnock L.","year":"2023","journal-title":"Cochrane Database of Systematic Reviews"},{"key":"e_1_2_11_3_1","volume-title":"Standards of Care and Good Clinical Practice for the Physiotherapy Management of Cystic Fibrosis Version 4","author":"Morrison L.","year":"2020"},{"issue":"1","key":"e_1_2_11_4_1","article-title":"Airway Clearance Techniques for Cystic Fibrosis: An Overview of Cochrane Systematic Reviews","volume":"1","author":"Wilson L. 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