title: Different frequencies should be prescribed for different high frequency chest compression machines.
abstract: High frequency chest compression (HFCC) is used for treatment and prevention of the lung diseases characterized by impaired mucus clearance and/or cough, where patients are at risk for acquiring acute bronchitis or pneumonia. The HFCC treatment frequencies may be prescribed according to the manufacturers' generic guidelines or may be determined for each individual patient by a "tuning" method that measures, at the mouth, the air volume displacement and the associated airflows produced at each frequency. Tuning is performed while the patient is breathing normally during the HFCC system operation. After measurements for several breaths at one frequency have been collected, the program randomly selects and measures another frequency until the entire frequency range of the machine being tuned has been sampled. Frequencies range from 6 to 21 Hz for the sine waveform machines and from 6 to 25 Hz for the square waveform machines. Each group of flow signals is digitized and analyzed by the program. For each frequency, the HFCC flow velocities and volumes are computed and averaged. These average flows and volumes are rank ordered; the three frequencies with the highest flows and the three frequencies producing the largest volumes are selected for prescription. If the same frequency is selected as one of the three best frequencies for both flow and volume, the next ranked frequency is selected randomly for flow or volume. Significant differences exist between patients and HFCC machines. In a series of 100 cystic fibrosis (CF) patients with varying degrees of lung disease, we found that the best-ranked frequencies varied from patient to patient and did not correlate with patients' age, gender, height, weight, or spirometry parameters. With the sine waveform, the highest HFCC airflows were between 13 and 20 Hz 82% of the time and the largest HFCC volumes were between 6 and 10 Hz 83% of the time. With the square waveform, both the highest average HFCC flow rates and the largest volume average HFCC displacements were between 6 and 14 Hz. Nevertheless, in this sample of 100 consecutive tunings, every frequency from 6 and 20 Hz was a best frequency for at least one patient. These findings provide the basis for recommending a tuning protocol to be used for prescribing frequencies with the various HFCC machines, because they are different from one another. If a patient's tuning cannot be done, it may be useful to prescribe the best frequencies based on the waveform machine he or she uses.
authors.affiliation: University of Minnesota Cystic Fibrosis Center, Minneapolis, MN, USA.
authors.forename: Carlos E
authors.initials: CE
authors.lastname: Milla
authors.forename: Leland G
authors.initials: LG
authors.lastname: Hansen
authors.forename: Warren J
authors.initials: WJ
authors.lastname: Warwick
mesh_terms: D000293:Adolescent; D000328:Adult; D000403:Airway Resistance; D001698:Biomedical Engineering / Q000379:methods*; D035641:Chest Wall Oscillation / Q000295:instrumentation*; D002648:Child; D003550:Cystic Fibrosis / Q000175:diagnosis / Q000628:therapy*; D004867:Equipment Design; D005260:Female; D006801:Humans; D008283:Maintenance; D008297:Male; D012129:Respiratory Function Tests; D012138:Respiratory Therapy / Q000295:instrumentation* / Q000379:methods