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

Ntoumenopoulos, George

doi:10.4187/respcare.01725

Cited by 1 publication

(1 citation statement)

References 12 publications

(24 reference statements)

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“…[4,23] Chatburn [15] reported that HFCWO may trigger a ventilator because the sensitivity of triggering a ventilator is usually set at very low pressure or flow (i.e., −2 cm H 2 O or 3 L/min), and because VEST changes the background pressure or inspired flow by more than -2 cm H 2 O or 3 L/min. [15] However, we did not observe any significant changes with regards to the ventilator settings (Table 2, all P > 0.05).…”

Section: Discussionmentioning

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

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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%