Comparison of active cycle of breathing and high‐frequency oscillation jacket in children with cystic fibrosis

Abstract

High-frequency chest compressions (HFCC) have been suggested as an alternative to conventional chest physiotherapy to aid sputum clearance in patients with cystic fibrosis (CF). We aimed to compare the active cycle of breathing techniques (ACBT) with the Hayek Oscillator Cuirass, performing HFCC on secretion clearance in children with CF during an exacerbation. Ten children (7 males; median age, 14 years; range, 9-16) received either two supervised sessions using HFCC or two self-treatment ACBT sessions in random order on successive days. Baseline pulmonary function was similar prior to treatments. Sputum weight increased significantly with ACBT compared with HFCC during treatment (5.2 g vs. 1.1 g, P < 0.005, morning; 4.1 g vs. 0.7 g, P < 0.01, afternoon). Pulmonary function improved significantly after morning ACBT (forced vital capacity (FVC): 2.67 l to 2.76 l, P < 0.03; forced expiratory volume in 1 sec (FEV1): 1.59 l to 1.62 l, P < 0.03). Following afternoon ACBT, there was a significant increase in FVC (2.64 to 2.79, P < 0.02), but no significant change in FEV1. Pulmonary function did not change at any time following HFCC. Compared with ACBT, HFCC by Hayek Cuirass is not an effective airway clearance treatment modality for children with CF during an infective exacerbation.

Short-Term Effects of High-Frequency Chest Compression and Positive Expiratory Pressure in Patients With Cystic Fibrosis

“…Other studies found no difference in pulmonary function [6-8], sputum production [6,7,9], and in oxygen saturation during or following treatments [8]. If compared with active cycle of breathing techniques, HFCC resulted less effective in improving lung volumes and mucus expectoration [10]…”

Short-term comparative study of high frequency chest wall oscillation and European airway clearance techniques in patients with cystic fibrosis

“…Phillips et al 18 compared HFCWO (using the Hayek Cuirass) with the active cycle of breathing techniques (ACBT) in hospitalised paediatric patients. Significantly more sputum was cleared with the ACBT.…”

Structure and Function of the Mucus Clearance System of the Lung

“…Precautions include endstage disease (end expiratory volume may fall below closing capacity), port under the vest (not currently accessed), recent esophageal surgery, distended abdomen, bronchospasm, osteoporosis, and coagulopathy (AARC 1991). HFCWO therapy has been compared with other airway clearance techniques in CF and other disease groups with pulmonary problems (Arens et al 1994;Braggion et al 1995;Kluft et al 1996;Scherer et al 1998;Oermann et al 2001;Phillips et al 2004;Yuan et al 2010;Fainardi et al 2011). A simulation tool to study high-frequency compression energy transfer mechanisms and waveforms has been developed for applications in pulmonary disease (O'Clock et al 2010).…”