Short-term comparative study of high frequency chest wall oscillation and European airway clearance techniques in patients with cystic fibrosis
OPEN ACCESS
- 1Population Genetics and Gene Therapy, National Heart and Lung Institute, Imperial College, London, UK
- 2Royal Brompton & Harefield NHS Foundation Trust, London, UK
- Correspondence to Dr Leyla Osman, Department of Physiotherapy, St Thomas' Hospital, Westminster Bridge Road, London SE1 7EH, UK; leyla.osman{at}gstt.nhs.uk
- Received 12 January 2009
- Accepted 31 July 2009
- Published Online First 23 August 2009
Abstract
Background High frequency chest wall oscillation (HFCWO) is standard treatment for airway clearance in the USA and has recently been introduced in the 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 patients with cystic fibrosis hospitalised with an infective pulmonary exacerbation.
Methods A 4-day randomised crossover design was used. Patients received either HFCWO on days 1 and 3 and usual ACTs on days 2 and 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.
Results 29 patients (72% male) of mean (SD) age 29.4 (8.4) years and mean (SD) forced expiratory volume in 1 s (FEV1) percentage predicted (FEV1%) 38 (16.7) completed the study. Significantly more sputum was expectorated during a single treatment session and over a 24 h period (mean difference 4.4 g and 6.9 g, respectively) with usual ACTs than with HFCWO (p<0.001). No statistically significant change in FEV1% or oxygen saturation was observed after either HFCWO or usual ACTs compared with baseline. 17 patients (55%) expressed a preference for their usual ACT.
Conclusions During both a finite treatment period and over 24 h, less sputum was cleared using HFCWO than usual ACT. HFCWO does not appear to cause any adverse physiological effects and may influence adherence.
Footnotes
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Linked articles122663.
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Hill-Rom did not participate in the design of this study, the collection, analysis and interpretation of data or in writing the manuscript.
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Funding A grant from the Robert Luff Foundation funded the lead researcher's post. Hill-Rom kindly provided two high-frequency chest wall oscillators (the Vest), disposable vests and tubes, two pulse oximeters and a spirometer for use in this study.
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Competing interests LO received reimbursement of registration, travel and accommodation expenses for attendance at the 20th North American Cystic Fibrosis Conference and an honorarium for speaking at a national workshop organised by Hill-Rom.
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Ethics approval Ethical approval was obtained from Brompton Harefield and National Heart and Lung Institute research ethics committee.
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Provenance and peer review Not commissioned; externally peer reviewed.
