Variation of sputum expectoration within day in bronchiectasis: Preliminary observational descriptive study

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Published: Apr 12, 2025
Keywords:
Sputum expectoration, sputum weight, airway clearance, bronchiectasis, physical therapy.

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Aung Aung Nwe
School of Physical Therapy, Faculty of Associated Medical Sciences, Khon Kaen University, Khon Kaen, Thailand.
https://orcid.org/0009-0007-1311-6853
Nimit Kosura
Department of Physical Therapy, Faculty of Medicine, Prince of Songkla University, Songkla Province, Thailand.
https://orcid.org/0000-0001-7660-8555
Chatchai Phimphasak
School of Physical Therapy, Faculty of Associated Medical Sciences, Khon Kaen University, Khon Kaen, Thailand.
https://orcid.org/0000-0001-6322-0746
Pornthip Barnludech
Innovation to Improve Cardiopulmonary and Physical Performance (IICP) Research Group, Khon Kaen University, Khon Kaen Province, Thailand.
Buranat Audsavachulamanee
School of Physical Therapy, Faculty of Associated Medical Sciences, Khon Kaen University, Khon Kaen, Thailand.
https://orcid.org/0000-0002-2135-7717
Chatchaya Jaimanee
School of Physical Therapy, Faculty of Associated Medical Sciences, Khon Kaen University, Khon Kaen, Thailand.
https://orcid.org/0009-0009-1990-4599
Aung Myo Htun
School of Physical Therapy, Faculty of Associated Medical Sciences, Khon Kaen University, Khon Kaen, Thailand.
https://orcid.org/0009-0005-5887-4186
Si Thu Aung
Department of Tropical Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen Province, Thailand.
https://orcid.org/0000-0003-2444-184X
Worawat Chumpangern
Pulmonary and Critical Care Medicine Unit, Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen Province, Thailand.
https://orcid.org/0000-0002-2564-6954
Pornanan Domthong
Division of Pulmonary and Critical Care Medicine, Department of Medicine, Khon Kaen Hospital, Khon Kaen Province, Thailand.
Wipa Reechaipichitkul
Pulmonary and Critical Care Medicine Unit, Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen Province, Thailand.
https://orcid.org/0000-0002-4536-6773
Uraiwon Chatchawan
School of Physical Therapy, Faculty of Associated Medical Sciences, Khon Kaen University, Khon Kaen, Thailand.
https://orcid.org/0000-0003-2109-0394
Wantana Siritaratiwat
School of Physical Therapy, Faculty of Associated Medical Sciences, Khon Kaen University, Khon Kaen, Thailand.
https://orcid.org/0000-0002-6893-7313
Chulee Ubolsakka-Jones
School of Physical Therapy, Faculty of Associated Medical Sciences, Khon Kaen University, Khon Kaen, Thailand.
https://orcid.org/0000-0002-4471-8220

Abstract

Background: Effective prescription of physical therapy airway clearance (ACT) is crucial for bronchiectasis patients, yet the optimal timing and frequency remain undefined. Understanding sputum expectoration patterns may determine the most suitable times for patients to undergo ACT.


Objective: This study aimed to investigate the daily sputum expectoration patterns in patients with bronchiectasis.


Materials and methods: Sputum was collected from ten bronchiectasis patients at home over three days, during morning (6 to 9 am), daytime (9 am to 6 pm), and evening (6 to 9 pm) periods. Collected sputum was centrifuged to remove saliva, weighed, and then converted to grams per hour for analysis.


Results: A total of 90 sputum containers were collected over three days from 10 patients. Most patients (N=8) expectorated a median (IQR) of 14.34 (7.96, 23.67) gm, showing a higher trend in the morning (2.07 (1.16, 4.03) gm/hr), followed by evening (1.18 (1.86, 1.92) g/hr) with the least during daytime (0.41 (0.32, 0.82) gm/hr). A minority of patients (N=2) with massive sputum production (72 and 63.98 for participant 1 and participant 2 respectively) exhibited the highest rate of expectoration during daytime (5.71 /hr), followed by the evening (3.83 /hr) and morning (1.69 /hr) on average over three days.


Conclusion: Most bronchiectasis patients exhibited higher rates of sputum expectoration in the morning and evening. Therefore, it is recommended to administer physical therapy for airway clearance twice daily, in the morning and evening, to prevent accumulation and enhance clearance.

Article Details

How to Cite
Nwe, A. A., Kosura, N., Phimphasak, C., Barnludech, P., Audsavachulamanee, B., Jaimanee, C., Htun, A. M., Aung, S. T., Chumpangern, W., Domthong, P., Reechaipichitkul, W., Chatchawan, U., Siritaratiwat, W., & Ubolsakka-Jones, C. (2025). Variation of sputum expectoration within day in bronchiectasis: Preliminary observational descriptive study. Journal of Associated Medical Sciences, 58(2), 297–304. retrieved from https://he01.tci-thaijo.org/index.php/bulletinAMS/article/view/274811
Issue
Vol. 58 No. 2 (2025): May-August
Section
Research Articles
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Personal views expressed by the contributors in their articles are not necessarily those of the Journal of Associated Medical Sciences, Faculty of Associated Medical Sciences, Chiang Mai University.

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