Neuromuscular

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  High Frequency Chest Wall Compression Therapy in neurologically impaired children.

  Fitzgerald K | Journal of Respiratory Care | 2014

  This study assessed the clinical feasibility of high-frequency chest wall oscillation  (HFCWO) therapy in neurologically impaired children with respiratory symptoms. The study found HFCWO may reduce the number of hospitalizations in neurologically impaired children.

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  Mechanical Insufflation-Exsufflation (MI-E) vs High-Frequency Chest Wall Oscillation (HFCWO) Rationale, Technology and Clinical Use

  Braverman J | 2014

  This paper focuses on the rationale underlying use of mechanical insufflation-exsufflation (MI-E) therapy and high-frequency chest wall oscillation (HFCWO) therapy. It includes, in a question and response format, a comparison of each modality in terms of mechanisms of action and patient selection criteria.

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  Annotated Bibliography Chronic Obstructive Pulmonary Disease (COPD): Rationale and Evidence for Secretion Management with High-Frequency Chest Wall Oscillation (HFCWO)

  2014

  This Annotated Bibliography provides an overview of recent literature concerning the causes and effects of mucus hypersecretion/retention in COPD with emphasis upon comorbid chronic bronchitis (CB) and bronchiectasis.

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  Effect of home MI-E on hospitalization and life style in neuromuscular disease: a pilot study

  Moran FCE | Journal of Pediatric Children's Health | 2013

  Retrospective chart reviews were performed in ten children with neuromuscular disorders,   Analysis of the data for patients with at least 6 months of device use showed significantly fewer hospital days.  Parents reported that MI-E had prevented several hospitilizations either by facilitating management of acute plugging or choking episodes or by preventing illnesses with regular daily secretion clearence.

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  Impact of High Frequency Chest Wall Oscillation on Healthcare Utilization in Patients with Neuromuscular Diseases

  Lechtzin N, et al. | Journal of Pediatric Children's Health | 2015

  Many people with neuromuscular disease (NMD) have difficulty clearing pulmonary secretions which may lead to pneumonia and respiratory failure.  High Frequency Chest Wall Oscillation (HFCWO) may help facilitate clearing of secretions.  This study evaluated the impact on healthcare utilization and cost when utilizing HFCWO therapy by comparing healthcare claims before and after initiation of HFCWO for patients with an NMD ICD9 code.  In an analysis of 426 patients, total medical costs per member per month reduced 12.4%, which equates to approximately $12,000 per patient annually. 

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  Comparison of High Frequency Chest Compression and Conventional Chest Physiotherapy in Hospitalized Patients With Cystic Fibrosis

  Arens R, et al. | American Journal of Respiratory Critical Care Medicine | 1994

  Fifty patients with cystic fibrosis (CF) admitted for acute pulmonary exacerbation were randomly selected to receive either high frequency chest compression (HFCC) or conventional physiotherapy (CPT) 3 times daily. Significant improvements in pulmonary function tests and clinical status were observed at 7 and 14 days of treatment in both groups. Length of hospital stay were similar between the 2 groups.

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  Effect of High Frequency Oral Airway and Chest Wall Oscillation and Conventional Chest Physical Therapy on Expectoration in Patients With Stable Cystic Fibrosis

  Scherer TA, et al. | CHEST | 1998

  14 patients with stable cystic fibrosis were enrolled in a randomized trial comparing high-frequency oral airway oscillation, high-frequency chest wall oscillation, and conventional chest physical therapy on airway secretions and pulmonary function. There were no significant differences in augmenting effects on sputum weights between these strategies. High frequency oscillation approaches have the potential to reduce health-care costs since they can be self-administered. 

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  A Comparison of Bronchial Drainage Treatments in Cystic Fibrosis

  Kluft J, et al. | Pediatric Pulmonology | 1996

  In this study, the effects of standard chest physical therapy and postural drainage were compared with the new high-frequency chest wall oscillation (HFCWO ) therapy. Twenty-nine stable cystic fibrosis patients between the ages of seven and fourty-seven were randomly assigned to alternate each form of therapy over a four day time period.The results showed that significantly more sputum was expectorated during high-frequency chest wall oscillation than during the standard chest physical therapy and postural drainage. This was determined by both the wet (P <0.001) and dry (P <0.01) measurements, concluding that HRCWO is at least as effective for clearing airway secretions as manual CPT/PD in cystic fibrosis patients.

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  Short-term Effects of Three Chest Physiotherapy Regimens in Patients Hospitalized for Pulmonary Exacerbations of Cystic Fibrosis: A Cross-over Randomized Study

  Braggion C, et al. | Pediatric Pulmonology | 1995

  In order to compare the short-term efficacy of three different chest physiotherapy (CPT) regimens, sixteen cystic fibrosis patients were randomly administered the three CPT procedures and a control-treatment (CONT). Each treatment was given a score by the patient for efficacy, and by both the patient and physio therapist for tolerance. The weight and dry weights of sputum collected during the sessions were greater for all CPT regimens than for the control-treatment (P <0.001, P <0.0001).

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  High-Frequency Chest Compression System to Aid in Clearance of Mucus From the Lung

  Hansen LG, et al. | Pediatric Pulmonology | 1990

  In order to compare the short-term efficacy of three different chest physiotherapy (CPT) regimens, sixteen cystic fibrosis patients were randomly administered the three CPT procedures and a control-treatment (CONT). Each treatment was given a score by the patient for efficacy, and by both the patient and physio therapist for tolerance. The weight and dry weights of sputum collected during the sessions were greater for all CPT regimens than for the control-treatment (P <0.001, P <0.0001).

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  Assessing Efficacy of High-Frequency Chest Wall Oscillation in Patients With Familial Dysautonomia

  Giarraffa P, et al. | Pediatric Pulmonology | 2005

  15 patients with familial dysautonomia were treated with high frequency chest wall oscillation therapy. Pulmonary function improvements were sustained, and significant improvements were seen in oxygen saturation and all other measured health outcomes (pneumonia, hospitalizations, antibiotic course and days, doctor visits, school absenteeism).

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  The Long-term Effect of High-Frequency Chest Compression Therapy on Pulmonary Complications of Cystic Fibrosis

  Warwick WJ, et al. | Pediatric Pulmonology | 1991

  This study examines the effects of a high-frequency chest compression device (HFCC) for clearance of mucous secretions from airways on sixteen cystic fibrosis patients. When utilizing the device consisting of a variable air-pulse delivery system and a non-stretch inflatable vest, 94% of patients' regression line slopes for percent predicted forced vital capacity (FVC) and forced expiratory volume in 1 second (FEV1) became more positive during self-administered HFCC therapy (P < 0.001). 

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  Validation of an Instrument Measuring Patient Satisfaction With Chest Physiotherapy Techniques in Cystic Fibrosis

  Oermann CM, et al. | CHEST | 2000

  Perceived efficacy, convenience, and comfort scores were determined from 129 surveys sent to patients with CF who used PDPV, Flutter and/or HFCWO techniques. Mean satisfaction scores revealed significant improvements in perceived efficacy with HFCWO compared to PDPV (P=0.045). Patient compliance was shown to correlate with satisfaction with prescribed therapies. 

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  A Cost Analysis of High-Frequency Chest Wall Oscillation in Cystic Fibrosis

  Ohnsorg F. | American Journal of Respiratory Critical Care Medicine | 1994

  This independent cost analysis investigated the impact of a high-frequency chest wall oscillation system on total health care expenditures in patients with cystic fibrosis. The study found that health care costs following the use of the system were reduced by 49%.

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  The Impact of Systematic Assessment and Early Volume Expansion and Secretion Clearance Intervention on Ventilator Associated Pneumonia

  Hewitt MJ, et al. | Journal of Respiratory Care | 2007

  This retrospective review evaluated the impact of the implementation of a protocol for early intervention with volume expansion and secretion clearance in ICU patients at risk for VAP. In the nine-month period following the change in protocol, the authors found a trend toward VAP rate reductions (P = 0.07). Additional studies are needed to evaluate the role of specific lung expansion and secretion clearance therapies in reducing ventilator-associated pneumonia.

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