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High Frequence Chest Wall Oscillation and Cystic Fibrosis

2014-08-27 03:16:21 | BioPortfolio

Summary

High frequency chest wall oscillation (HFCWO) has been shown to increase tracheal mucus clearance compared with a control group. These observations led to the development of The Vest® which is a non-stretchable jacket connected to an air-pulse generator and worn by the patient over the chest wall. The generator rapidly inflates and deflates The Vest®, which gently compresses and releases the chest wall between 5 and 20 times per second. This generates mini-coughs that are said to dislodge mucus from the bronchial walls and to facilitate its movement up the airways. The Vest® has been shown to reduce the viscosity of mucus and this should further enhance mucus clearance.

People with cystic fibrosis (CF), admitted to hospital with an acute infective pulmonary exacerbation, should increase the frequency and duration of their airway clearance sessions owing to the increase in quantity and viscosity of purulent bronchial secretions.In the United Kingdom, and in many other countries, the availability of physiotherapists to assist with the recommended number of daily treatments is insufficient to meet patient need. If the use of high frequency chest wall oscillation, in addition to 'usual' self airway clearance techniques, in the early morning and evening was to facilitate recovery from an exacerbation, this would indicate an important place for high frequency chest wall oscillation in the management of people with cystic fibrosis.

Hypothesis:

The addition of high frequency chest wall oscillation to twice daily supervised physiotherapy is as effective as the addition of self treatment in facilitating recovery from an acute infective pulmonary exacerbation, as measured by improvement in lung function, specifically forced expiratory volume in one second (FEV1).

Study Design

Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Treatment

Conditions

Cystic Fibrosis

Intervention

High Frequency Chest Wall Oscillation (HFCWO), Usual airway clearance

Location

Royal Brompton & Harefield NHS Foundation Trust
London
United Kingdom

Status

Not yet recruiting

Source

Imperial College London

Results (where available)

View Results

Links

Published on BioPortfolio: 2014-08-27T03:16:21-0400

Clinical Trials [1730 Associated Clinical Trials listed on BioPortfolio]

Study Assessing High-Frequency Chest Wall Oscillation (HFCWO) in Preventing Pulmonary Exacerbations

To demonstrate that airway clearance provided by Vest therapy reduces the frequency of respiratory exacerbations requiring hospitalization or antibiotic utilization in patients with muscle...

Airway Clearance Using High Frequency Chest Wall Oscillation

High frequency chest wall oscillation (HFCWO) has been shown to increase tracheal mucous clearance compared with control. These observations led to the development of 'The Vest' which is a...

High Frequency Chest Wall Oscillation in Chronic Obstructive Pulmonary Disease (COPD)

Patients with Chronic obstructive pulmonary disease (COPD) tend to have cough, excess mucus production and breathlessness as cardinal features. The excess mucus production often leads to f...

HFCWO in Hospitalized Asthmatic Children

To determine whether or not high frequency chest wall oscillation (in the form of the VestTM) is superior to regular asthma therapy in the management of children hospitalized with moderate...

HFCWO on Pneumonic Respiratory Failure

BACKGROUND: Endotracheal intubation and prolonged immobilization of patients receiving mechanical ventilation may reduce expectoration function. High frequency chest wall oscillation (HFCW...

PubMed Articles [18650 Associated PubMed Articles listed on BioPortfolio]

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Medical and Biotech [MESH] Definitions

A respiratory support system used to remove mucus and clear airway by oscillating pressure on the chest.

Ventilatory support system using frequencies from 60-900 cycles/min or more. Three types of systems have been distinguished on the basis of rates, volumes, and the system used. They are high frequency positive-pressure ventilation (HFPPV); HIGH-FREQUENCY JET VENTILATION; (HFJV); and high-frequency oscillation (HFO).

RESPIRATORY MUSCLE contraction during INHALATION. The work is accomplished in three phases: LUNG COMPLIANCE work, that required to expand the LUNGS against its elastic forces; tissue resistance work, that required to overcome the viscosity of the lung and chest wall structures; and AIRWAY RESISTANCE work, that required to overcome airway resistance during the movement of air into the lungs. Work of breathing does not refer to expiration, which is entirely a passive process caused by elastic recoil of the lung and chest cage. (Guyton, Textbook of Medical Physiology, 8th ed, p406)

Body ventilators that assist ventilation by applying intermittent subatmospheric pressure around the thorax, abdomen, or airway and periodically expand the chest wall and inflate the lungs. They are relatively simple to operate and do not require tracheostomy. These devices include the tank ventilators ("iron lung"), Portalung, Pneumowrap, and chest cuirass ("tortoise shell").

The measurement of frequency or oscillation changes.

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