Short-term comparative study of high frequency chest wall oscillation and European airway clearance techniques in patients with cystic fibrosis.
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 (FEV(1)) percentage predicted (FEV(1)%) 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 FEV(1)% 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.
Osman
Leyla P
LP
Population Genetics and Gene Therapy, National Heart and Lung Institute, Imperial College, London, UK. leyla.osman@gstt.nhs.uk
Roughton
Michael
M
Hodson
Margaret E
ME
Pryor
Jennifer A
JA
D000328:Adult; D035641:Chest Wall Oscillation / Q000379:methods*; D018592:Cross-Over Studies; D003550:Cystic Fibrosis / Q000097:blood / Q000503:physiopathology / Q000628:therapy*; D005260:Female; D005541:Forced Expiratory Volume; D006801:Humans; D008297:Male; D010100:Oxygen / Q000097:blood; D010313:Partial Pressure; D017060:Patient Satisfaction; D026741:Physical Therapy Modalities; D013183:Sputum / Q000502:physiology; D016896:Treatment Outcome; D055815:Young Adult
D010100:Oxygen
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