title: High-frequency chest wall compression therapy in neurologically impaired children.
abstract: BACKGROUND
  Children with neurological impairment often suffer from insufficient airway secretion clearance, which substantially increases their respiratory morbidity. The goal of the study was to assess the clinical feasibility of high-frequency chest wall compression (HFCWC) therapy in neurologically impaired children with respiratory symptoms.
  
  
  METHODS
  This was a single-center, investigator initiated, prospective study. Twenty-two subjects were studied for 12 months before and 12 months after initiation of HFCWC therapy, and 15 subjects were followed for an additional 12 months. The threshold of adherence to HFCWC therapy was 70%. The number of pulmonary exacerbations that required hospitalization was recorded.
  
  
  RESULTS
  Forty-five percent of the subjects required hospital admission before initiation of HFCWC therapy. This rate decreased to 36% after the first year with HFCWC, and to 13% after the second year with HFCWC. There was a statistically significant reduction of the number of hospital days at follow-up, relative to before treatment. Use of an assisted-cough device or the presence of tracheostomy did not significantly affect hospitalization days.
  
  
  CONCLUSIONS
  Regular HFCWC therapy may reduce the number of hospitalizations in neurologically impaired children.
authors.affiliation: Division of Pediatric Pulmonology, Maimonides Infants and Children's Hospital, Brooklyn, New York.
authors.forename: Kathryn
authors.initials: K
authors.lastname: Fitzgerald
authors.forename: Jessica
authors.initials: J
authors.lastname: Dugre
authors.forename: Sobhan
authors.initials: S
authors.lastname: Pagala
authors.forename: Peter
authors.initials: P
authors.lastname: Homel
authors.forename: Michael
authors.initials: M
authors.lastname: Marcus
authors.forename: Mikhail
authors.initials: M
authors.lastname: Kazachkov
mesh_terms: D000293:Adolescent; D035641:Chest Wall Oscillation; D002648:Child; D002675:Child, Preschool; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D009079:Mucociliary Clearance; D009422:Nervous System Diseases / Q000150:complications; D010349:Patient Compliance; D011446:Prospective Studies; D012131:Respiratory Insufficiency / Q000209:etiology / Q000503:physiopathology* / Q000628:therapy*; D013997:Time Factors
keywords: high-frequency chest wall compression; hospitalization; neurological impairment; respiratory; secretion clearance