Continuous positive airway pressure and body position alter lung clearance of the radiopharmaceutical 99mtechnetium-diethylenetriaminepentaacetic acid (99mTc-DTPA)

The purpose of this investigation was to evaluate the pulmonary clearance rate of 99mtechnetium-diethylenetriaminepentaacetic acid (99mTc-DTPA) through the use of continuous positive airway pressure (CPAP) in different postures. It was a quasi-experimental study involving 36 healthy individuals with normal spirometry. 99mTc-DTPA, as aerosol, was nebulized for 3 min with the individual in a sitting position. The pulmonary clearance rate was assessed through pulmonary scintigraphy under spontaneous breathing and under 20 and 10 cmH2O CPAP in the sitting and supine positions. The clearance rate was expressed as the half-time (T1/2), that is, the time for the activity to decrease to 50% of the peak value. 20 cmH2O CPAP produced significant reduction of the T1/2 of 99mTc-DTPA in the supine position (P = 0.009) and in the sitting position (P = 0.005). However, 10 cmH2O CPAP did not alter the T1/2 of DTPA in both positions. The postural variation from supine to the sitting position with 10 cmH2O CPAP (P = 0.01) and 20 cmH2O (P = 0.02) also reduced the T1/2 of 99mTc-DTPA. High levels of positive pressure in normal lungs resulted in faster 99mTc-DTPA clearance. Moreover, the sitting position further increased the clearance rate of the 99mTc radioaerosol imaging in the two pressure levels studied.Key words: Continuous positive airway pressure, 99mTc-DTPA, scintigraphy, posture