High‐Frequency Chest Compression: A Summary of the Literature

Abstract

The purpose of the present literature summary is to describe high-frequency chest compression (HFCC), summarize its history and outline study results on its effect on mucolysis, mucus transport, pulmonary function and quality of life. HFCC is a mechanical method of self-administered chest physiotherapy, which induces rapid air movement in and out of the lungs. This mean oscillated volume is an effective method of mucolysis and mucus clearance. HFCC can increase independence. Some studies have shown that HFCC leads to more mucus clearance and better lung function compared with conventional chest physiotherapy. However, HFCC also decreases end-expiratory lung volume, which can lead to increased airway resistance and a decreased oscillated volume. Adding positive end-expiratory pressure to HFCC has been shown to prevent this decrease in end-expiratory lung volume and to increase the oscillated volume. It is possible that the HFCC-induced decrease in end-expiratory lung volume may result in more mucus clearance in airways that remain open by reducing airway size. Adjunctive methods, such as positive end-expiratory pressure, may not always be needed to make HFCC more effective.

High-Frequency Chest Wall Compressions: Good for the Patient? Good for the Clinician?

“…11 HFCWC for secretion clearance during an exacerbation of cystic fibrosis may predispose the patient to substantial arterial desaturation, 11 presumably to the airway collapse associated with reductions in end-expiratory lung volumes. 8 In approximately 70% of patients in the trial 9 the indications for chest physical therapy included acute lobar atelectasis. It is unclear why HFCWC would be prescribed for the management of acute lobar atelectasis, unless it was due to secretion retention, considering the reductions in end-expiratory lung volume.…”

“…Positive expiratory pressure and CCPT may be better tolerated (stable oxygenation) during exacerbations of cystic fibrosis, 11 and the combination of positive expiratory pressure with HFCWC may improve tolerance and efficacy of therapy. 8 There may also be potential risks with the use of HFCWC to augment secretion clearance in specific disease groups. Central airway occlusion and respiratory distress may occur in patients with poor cough or very tenacious secretions (eg, bronchial casts, severe neuromuscular diseases), unless HFCWC is combined with noninvasive ventilation, 12,13 nasopharyngeal airway suctioning, mechanical in-exsufflation, 14 or some form of airway control (endotracheal intubation/tracheostomy to facilitate airway suctioning).…”

“…[5][6][7] High-frequency chest wall compressions (HFCWC) is a novel mechanical method applied by a vibratory vest, which induces rapid air movement in and out of the lungs to induce mucolysis and mucus clearance. 8 HFCWC has been advocated as a means to standardize the delivery of chest physiotherapy and eliminate of the need for therapist administered treatments. 9 Clinkscale et al 9 also state that, as "conventional chest physical therapy has been associated with various complications, including hypoxemia, arrhythmias, and increased intracranial hypertension, as well as carpal tunnel syndrome for the therapists or nurses providing the treatments," [2][3][4] this is further justification for a randomized controlled trial comparison with HFCWC.…”

Kistik Fibrozisli Hastalarda Yüksek Frekanslı Göğüs Duvarı Ossilasyonu Uygulamasının Etkileri

“…Aralıklı hava akışının çeşitli frekanslarda göğüs duvarını hızla komprese etmesi ve serbestleştirmesi ile havayolları içindeki hava akışında bir ossilasyon oluşturur (6). YFGDO uygulamasının, ekspiratuar akışta geçici bir artış, öksürük benzeri parçalama kuvveti üretimi ve mukus viskoelastisitesinde azalma sağlayarak mukosiliyer temizliği geliştirdiği ve santral ve periferal mukus temizliğini arttırdığı gösterilmiştir (6)(7)(8).…”

Pilot Study: Understanding the Effects of Voicing Intervention on HFCC Therapy in People with Cystic Fibrosis

“…1,2 Early HFCC research with animal models suggest that the technology may be adapted for human use to provide more effective and efficient secretion clearance therapy than labor-intensive, less reliable manual chest physiotherapy (mCPT). 3,4 In the late 1980s, Warwick and Hansen at the University of Minnesota developed a prototype machine suitable for patient's use.…”