Does high-frequency chest wall oscillation therapy have any impact on the infective exacerbations of chronic obstructive pulmonary disease? A randomized controlled single-blind study

Göktalay, Tuğba; Akdemir, Selim Erkan; Alpaydın, Aylin Özgen; Coşkun, Ayşın Şakar; Çeli̇k, Pınar; Yorgancıoğlu, Arzu

doi:10.1177/0269215513478226

Cited by 11 publications

(21 citation statements)

References 18 publications

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“…[12,13] We speculate that these variables may not directly indicate the efficacy of oscillation, [29,30] but may be more related to other factors such as disease severity [14] or quality of care. Further longitudinal controlled large-scale studies are warranted to elucidate this issue.…”

Section: Discussionmentioning

confidence: 99%

“…[9] High-frequency chest wall oscillation (HFCWO), mimicking a “mini-cough” by compressing and relaxing the chest wall to generate an oscillated volume from the lungs, can dislodge airway secretions as efficiently as CCPT [4,9,10] and can therefore save manpower to conduct CCPT. [11] However, most studies that have reported no significant effects of HFCWO, as these outcome measurements focusing on mortality, hospital stay, [4] lung function [12,13] or BODE score (a multidimensional 10-point scale for evaluation of chronic obstructive pulmonary disease) [12] are not associated with the immediate effects of chest physical therapy and may be seriously affected by other factors such as disease severity. [14] Using the amount of sputum as the outcome measurement of HFCWO is not strongly recommended.…”

Section: Introductionmentioning

confidence: 99%

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Instantaneous responses to high-frequency chest wall oscillation in patients with acute pneumonic respiratory failure receiving mechanical ventilation

Chuang

Chou²,

Lee³

et al. 2017

Medicine

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Background:Endotracheal intubation and prolonged immobilization of patients receiving mechanical ventilation may reduce expectoration function. High-frequency chest wall oscillation (HFCWO) may ameliorate airway secretion movement; however, the instantaneous changes in patients’ cardiopulmonary responses are unknown. Moreover, HFCWO may influence ventilator settings by the vigorous oscillation. The aim of this study was to investigate these issues.Methods:Seventy-three patients (52 men) aged 71.5 ± 13.4 years who were intubated with mechanical ventilation for pneumonic respiratory failure were recruited and randomly classified into 2 groups (HFCWO group, n = 36; and control group who received conventional chest physical therapy (CCPT, n = 37). HFCWO was applied with a fixed protocol, whereas CCPT was conducted using standard protocols. Both groups received sputum suction after the procedure. Changes in ventilator settings and the subjects’ responses were measured at preset intervals and compared within groups and between groups.Results:Oscillation did not affect the ventilator settings (all P > 0.05). The mean airway pressure, breathing frequency, and rapid shallow breathing index increased, and the tidal volume and SpO2 decreased (all P < 0.05). After sputum suction, the peak airway pressure (Ppeak) and minute ventilation decreased (all P < 0.05). The HFCWO group had a lower tidal volume and SpO2 at the end of oscillation, and lower Ppeak and tidal volume after sputum suction than the CCPT group.Conclusions:HFCWO affects breathing pattern and SpO2 but not ventilator settings, whereas CCPT maintains a steadier condition. After sputum suction, HFCWO slightly improved Ppeak compared to CCPT, suggesting that the study extends the indications of HFCWO for these patients in intensive care unit. (ClinicalTrials.gov number NCT02758106, retrospectively registered.)

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Instantaneous responses to high-frequency chest wall oscillation in patients with acute pneumonic respiratory failure receiving mechanical ventilation

Chuang

Chou²,

Lee³

et al. 2017

Medicine

View full text Add to dashboard Cite

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“…2016. Most studies were randomized control trials (n = 31) 15,16, conducted with inpatients (n = 27), 15,16,29,30,33,35,[37][38][39][40][41]43,[45][46][47][48][51][52][53][54][55][56][57][58][59][60][61] followed by hospital outpatient departments (n = 6), 15,37,38,42,44,49 inpatients plus patients' homes (n = 3), 31,32,50 community settings (n = 3), 34,62,63 and patients' homes (n = 1) 36 (Tabs. 1 and 2).…”

Section: Phase 1: Measures Used In Pulmonary Rehabilitationmentioning

confidence: 99%

Outcome Measures Used in Pulmonary Rehabilitation in Patients With Acute Exacerbation of Chronic Obstructive Pulmonary Disease: A Systematic Review

Oliveira

Marques

2017

Physical Therapy

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Background Conflicting results about the effects of community-based pulmonary rehabilitation in acute exacerbations of chronic obstructive pulmonary disease (AECOPD) exist, possibly because the variety of outcome measures used and the lack of appropriate measurement properties hinder the development of pulmonary rehabilitation guidelines. Purpose The purpose of this study was to identify and review the measurement properties of patient-reported outcome measures (PROMs) and clinical outcome measures of AECOPD that are used in pulmonary rehabilitation and that can be easily applied in a community setting. Data Sources PubMed, Web of Science, Scopus, and CINAHL were searched up to July 1, 2016. Study Selection Phase 1 identified outcome measures used in pulmonary rehabilitation for AECOPD. Phase 2 reviewed the measurement properties of the identified outcome measures. Data Extraction One reviewer extracted the data and 2 reviewers independently assessed the methodological quality of the studies and the measurement properties of the outcome measures by using the Consensus-Based Standards for the Selection of Health Status Measurement Instruments (COSMIN) recommendations. Data Synthesis Twenty-three PROMs and 18 clinical outcome measures were found. The outcome measures most used were the St George Respiratory Questionnaire (n = 15/37 studies) and the 6-minute walk test (n = 21/37 studies). Thirty-two studies described the measurement properties of 22 PROMs and 7 clinical outcome measures. The methodological quality of the studies was mostly poor, and the measurement properties were mostly indeterminate. The outcome measure exhibiting more robust properties was the COPD Assessment Test. Limitations A number of studies were not found with the validated search strategy used and were included a posteriori; the fact that 3 studies presented combined results— for patients who were stable and patients with exacerbation—affected the conclusions that can be drawn. Conclusions A large variety of outcome measures have been used; however, studies on their measurement properties are needed to enhance the understanding of community pulmonary rehabilitation for AECOPD.

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“…The total CAT score was calculated by summing the points of each variable, the higher scores represent worse health. [8][9][10][11][12] It was classified into four categorizes; low (< 10), medium (10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20), high (21)(22)(23)(24)(25)(26)(27)(28)(29)(30) and very high (> 30). (FEV1% pred = predicted amount as a percentage of the forced expiratory lung volume in one second; 6MWD = six minute walking distance; MMRC = modified medical research council dyspnea scale; BMI = body mass index.…”

Section: Copd Assessment Test (Cat)mentioning

confidence: 99%

“…5,22,23 The patient was positioned in a relaxed and comfortable position either sitting upright or lying down, as no special position is recommended. No sessions immediately after a meal.…”

Section: High-frequency Chest Wall Oscillation (Hfcwo)mentioning

confidence: 99%

Utility of vest high frequency chest wall oscillation device versus flutter device in acute exacerbation of chronic obstructive pulmonary disease

Farag

El-Syed

2017

Int J Res Med Sci

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Background: Objectives to assess the effectiveness of high frequency chest wall oscillation (HFCWO) vest system and Flutter devices in the treatment of patients with AECOPD, and to compare the efficacy of HFCWO vest system versus Flutter devices.Methods: We conducted an interventional study on 108 out of 129 patients presented with AECOPD, recruited from two-university hospitals. They were classified into three groups, HFCWO group (n=37), Flutter group (n=35), and control group (n=36). The HFCWO group and Flutter group were treated with AECOPD medications in addition to either HFCWO or Flutter physiotherapy, three sessions per week, for four weeks, while control group was treated by medications only. All patients were evaluated before and after treatment by spirometry, ABG, CAT score, and the BODE index.Results: Post treatment assessment for both HFCWO and Flutter groups demonstrated that most of spirometric indices (FEV1%, FVC%, FEV1/FVC %), oxygenations parameters (PaO2, SaO2 %) and CAT score, were significantly improved (p < 0.05). The level of perceived dyspnea decreased significantly, walking distance during 6-MWT was extended significantly, the BODE index and MMRC scale decreased significantly. While in control group only oxygenations parameters (PaO2, SaO2 %) was mildly improved. No statistical significant difference was found between vest HFCWO and Flutter device in all measured post treatment parameters (p > 0.05).Conclusions: Both vest HFCWO and Flutter device are highly effective in treatment of patients with AECOPD in terms of improvement in ventilatory function and oxygenation parameters with better exercise tolerance.

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Does high-frequency chest wall oscillation therapy have any impact on the infective exacerbations of chronic obstructive pulmonary disease? A randomized controlled single-blind study

Abstract: The application of high-frequency chest wall oscillation therapy offers no additional advantages on infective exacerbations in chronic obstructive pulmonary disease.

Cited by 11 publications

References 18 publications

Instantaneous responses to high-frequency chest wall oscillation in patients with acute pneumonic respiratory failure receiving mechanical ventilation

Instantaneous responses to high-frequency chest wall oscillation in patients with acute pneumonic respiratory failure receiving mechanical ventilation

Outcome Measures Used in Pulmonary Rehabilitation in Patients With Acute Exacerbation of Chronic Obstructive Pulmonary Disease: A Systematic Review

Utility of vest high frequency chest wall oscillation device versus flutter device in acute exacerbation of chronic obstructive pulmonary disease

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