title: High-frequency chest wall oscillation successful in controlling refractory asthma.
abstract: BACKGROUND
  High-frequency chest wall oscillation (HFCWO) has been traditionally implemented for airway secretion clearance in conditions such as cystic fibrosis (CF) and bronchiectasis. There have been few reports of its use in refractory asthma.
  
  
  METHODS
  A 36-year-old, non-smoker male presented with a lifelong history of poorly controlled asthma. Despite multiple controller medications, he reported daily chest congestion, copious phlegm, and frequent exacerbations. Imaging, blood work, and bronchoscopy ruled out atypical infections, immunodeficiency, CF, and other chronic conditions. Pulmonary function tests supported a diagnosis of asthma.
  
  
  RESULTS
  We initiated HFCWO therapy twice daily in addition to standard inhaled pharmacological therapy. After 2 months, the patient noted resolution of respiratory symptoms as well as improvement in lung function. He remained symptom-free at his 2-year follow-up.
  
  
  CONCLUSIONS
  High-frequency chest oscillation may be useful in phenotypes of asthma characterized by prominent mucus hypersecretion.
authors: Division of Pulmonary and Critical Care Medicine, Johns Hopkins University, Baltimore, MD 21205, USA. sbose7@jhmi.edu
authors: Sonali
authors: S
authors: Bose
authors: Jonathan
authors: J
authors: Jun
authors: Gregory B
authors: GB
authors: Diette
mesh_terms: D000328:Adult; D001249:Asthma / Q000503:physiopathology / Q000628:therapy*; D035641:Chest Wall Oscillation / Q000379:methods* / Q000592:standards; D005541:Forced Expiratory Volume / Q000502:physiology; D006801:Humans; D008297:Male
references: N Engl J Med. 2010 Dec 2;363(23):2233-47
references: 21121836
references: J Allergy Clin Immunol. 2009 Oct;124(4):681-7.e3
references: 19665764
references: Respir Care. 2004 Nov;49(11):1335-8
references: 15507168
references: Pediatr Pulmonol. 1990;9(3):146-51
references: 2277735
references: Crit Care. 2002 Feb;6(1):30-44
references: 11940264
references: Respir Res. 2011 Sep 10;12:120
references: 21906390
references: Proc Am Thorac Soc. 2009 May 1;6(3):301-5
references: 19387034
references: J Microbiol Immunol Infect. 2001 Jun;34(2):92-6
references: 11456366
references: Cochrane Database Syst Rev. 2005 Apr 18;(2):CD001002
references: 15846609