Comparison of high frequency chest compression and conventional chest physiotherapy in hospitalized patients with cystic fibrosis.

Abstract

Clearance of bronchial secretions is essential in the management of cystic fibrosis (CF) patients admitted for acute pulmonary exacerbation. Conventional physiotherapy (CPT) is labor-intensive, time-consuming, expensive, and may not be available as frequently as desired during hospitalization. High frequency chest compression (HFCC), which uses an inflatable vest linked to an air-pulse delivery system, may offer an attractive alternative. To study this, we prospectively studied 50 CF patients admitted for acute pulmonary exacerbation who were randomly allocated to receive either HFCC or CPT three times a day. On admission, clinical status and pulmonary function tests (PFT) in the HFCC group were not significantly different from those measured in the CPT group. Significant improvements in clinical status and PFT were observed after 7 and 14 d of treatment, and were similar in the two study groups, leading to patient discharge after similar periods of hospitalization. We conclude that HFCC and CPT are equally safe and effective when used during acute pulmonary exacerbations in CF patients. We speculate that HFCC may provide an adequate alternative in management of CF patients in a hospital setting.

Challenges in the Understanding and Treatment of Amyotrophic Lateral Sclerosis/Motor Neuron Disease

“…Physical techniques such as breath stacking and assisted cough, as well as medication management (bronchodilators, anticholinergic agents), have become increasingly common in aggressive multidisciplinary treatment settings. In addition, use of intrasalivary gland injection of botulinum toxin has been shown to result in significant improvement of sialorrhea and improve respiratory insufficiency [130,131].…”

Safety and Efficacy of Short-Term Intrapulmonary Percussive Ventilation in Patients With Bronchiectasis

“…At T1 we also measured the patient's subjective discomfort with a 0 -100% discomfort visual analog scale. 20 We also measured the volume and wet and dry weight of collected sputum. We asked the patients about adverse effects throughout the 30-min treatment session and at T3.…”

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“…Additionally, CPT is labor-intensive, and low treatment adherence rates, hypoxemia, and discomfort have been reported among patients. 3 Evidence indicates that CPT can provide effective airway clearance, preserving pulmonary function and minimizing complications. Researchers in many studies 4,5 have reported small-scale benefit of CPT on pulmonary end points.…”

“…7 As an alternative, contemporary high-frequency chest wall oscillation (HFCWO) may increase rates of lung recovery thanks to the technique's controlled electronic selections of frequency and pressure amplitude. 8,9 Previous comparative studies 3,10,11 have shown HFCWO to be as effective as CPT in clearing pulmonary secretions among patients with chronic pulmonary disease in mostly outpatient settings. Additionally, HFCWO is not operator-dependent, does not require specialized positions, and may be less painful than CPT.…”

“…[12][13][14] To date, most studies have compared HFCWO with CPT in patients with chronic pulmonary diseases, mainly cystic fibrosis, in both inpatient and outpatient settings. 3,10,11 Two studies 10,15 used a randomized design to compare HFCWO and CPT on outcome variables of comfort and preference. According to the literature, 2,3,10,11,16 patients with cystic fibrosis and a variety of thoracic surgery patients reported little or no discomfort during therapy and preferred HFCWO to conventional CPT.…”