HFCWO is not better than standard airway clearance in CF

As Bradley points out in her editorial accompanying the paper by Osman and colleagues in this month's Thorax, airway clearance is rated as one of the most troublesome components of treatment of cystic fibrosis (CF). The active cycle of breathing techniques (ACT) has been the standard airway clearance protocol in the UK, although in the USA high frequency chest wall oscillation (HFCWO) has been promoted. However, there has been some demand from patients with CF for HFCWO even though the evidence for its effectiveness has been limited. Osman and colleagues describe a crossover trial comparing HFCWO with standard ACT. Surprisingly less sputum was cleared with HFCWO than with ACT and there were no effects on other outcomes in this …