A short-term comparative study of high frequency chest wall oscillation and European airway clearance techniques in people with cystic fibrosis

Leyla P Osman ^1*, Michael Roughton ², Margaret E Hodson ³ and Jennifer A Pryor ²

¹ Imperial College; Royal Brompton and Harefield NHS Trust, United Kingdom
² Royal Brompton and Harefield NHS Trust, United Kingdom
³ Royal Imperial College; Brompton and Harefield NHS Trust, United Kingdom

^* To whom correspondence should be addressed. E-mail: leyla.osman{at}gstt.nhs.uk.

Accepted 31 July 2009

Abstract

High frequency chest wall oscillation (HFCWO) is standard treatment for airway clearance in the United States of America, and has recently been introduced to the United Kingdom (UK) and Europe. There is little published research comparing HFCWO with airway clearance techniques (ACTs) frequently used in the UK and Europe. The aim of this study was to compare the short-term effects of HFCWO with usual ACTs in people with cystic fibrosis hospitalised with an infective pulmonary exacerbation.

A four-day randomised cross-over design was used. Patients received either HFCWO on Days 1 & 3 and usual ACTs on Days 2 & 4 or vice versa. Wet weight of sputum, spirometry and oxygen saturation were measured. Perceived efficacy, comfort, incidence of urinary leakage and preference were assessed. Data were analysed by mixed model analysis.

Twenty-nine patients, (72% male) mean age in years (sd) 29.4 (8.4) and mean FEV1 as percent predicted (FEV1%) (sd) 38 (16.7) completed the study. Statistically significantly more sputum was expectorated during a single treatment session and over a 24 hour period (mean difference 4.4g and 6.9g respectively; p < 0.001), with usual ACTs than HFCWO. No statistically significant change in FEV1% or oxygen saturation was observed after either HFCWO or usual ACTs, compared with baseline. Seventeen (55%) patients expressed a preference for their usual ACT.

During both a finite treatment period and over 24 hours less sputum was cleared using HFCWO than usual ACT. HFCWO does not appear to cause any adverse physiological affects and may influence adherence.

Registered at ClinicalTrials.gov NCT00817947