scholarly journals Physiologic Evidence for High-Frequency Chest Wall Oscillation and Positive Expiratory Pressure Breathing in Hospitalized Subjects With Cystic Fibrosis

2005 ◽  
Vol 85 (12) ◽  
pp. 1278-1289 ◽  
Author(s):  
Joan C Darbee ◽  
Jamshed F Kanga ◽  
Patricia J Ohtake
Keyword(s):  
Cystic Fibrosis ◽  
Lung Function ◽  
Chest Wall ◽  
High Frequency ◽  
Gas Mixing ◽  
Ventilation Distribution ◽  
Oxyhemoglobin Saturation ◽  
Arterial Blood ◽  
Wall Oscillation ◽  
Positive Expiratory Pressure

Abstract Background and Purpose. This investigation identified ventilation distribution, gas mixing, lung function, and arterial blood oxyhemoglobin saturation (Spo2) physiologic responses to 2 independent airway clearance treatments, high-frequency chest wall oscillation (HFCWO) and low positive expiratory pressure (PEP) breathing, for subjects who had cystic fibrosis (CF) and who were hospitalized during acute and subacute phases of a pulmonary exacerbation. Subjects. Fifteen subjects with moderate to severe CF were included in this study. Methods. Subjects performed single-breath inert gas tests and spirometry before and immediately after HFCWO and PEP breathing at admission and discharge. Arterial blood oxyhemoglobin saturation was monitored throughout each treatment. Results. At admission and discharge, PEP breathing increased Spo2 during treatment, whereas HFCWO decreased Spo2 during treatment. Ventilation distribution, gas mixing, and lung function improved after HFCWO or PEP breathing. Discussion and Conclusion. High-frequency chest wall oscillation and PEP breathing are similarly efficacious in improving ventilation distribution, gas mixing, and pulmonary function in hospitalized people with CF. Because Spo2 decreases during HFCWO, people who have moderate to severe CF and who use HFCWO should have Spo2 monitored during an acute exacerbation.

scholarly journals Physiologic Evidence for the Efficacy of Positive Expiratory Pressure as an Airway Clearance Technique in Patients With Cystic Fibrosis

2004 ◽  
Vol 84 (6) ◽  
pp. 524-537 ◽  
Author(s):  
Joan C Darbee ◽  
Patricia J Ohtake ◽  
Brydon JB Grant ◽  
Frank J Cerny
Keyword(s):  
Cystic Fibrosis ◽  
Lung Function ◽  
Vital Capacity ◽  
Preliminary Investigation ◽  
Therapeutic Modality ◽  
Gas Mixing ◽  
Ventilation Distribution ◽  
Single Breath ◽  
Arterial Blood ◽  
Positive Expiratory Pressure

Abstract Background and Purpose. Individuals with cystic fibrosis (CF) have large amounts of infected mucus in their lungs, which causes irreversible lung tissue damage. Although patient-administered positive expiratory pressure (PEP) breathing has been promoted as an effective therapeutic modality for removing mucus and improving ventilation distribution in these patients, the effects of PEP on ventilation distribution and gas mixing have not been documented. Therefore, this preliminary investigation described responses in distribution of ventilation and gas mixing to PEP breathing for patients with moderate to severe CF lung disease. Subjects and Methods. The effects of PEP breathing on ventilation distribution, gas mixing, lung volumes, expiratory airflow, percentage of arterial blood oxyhemoglobin saturation (Spo2), and sputum volume were studied in 5 patients with CF (mean age=18 years, SD=4, range=13–22) after no-PEP, low-PEP (10–20 cm H2O), and high-PEP (>20 cm H2O) breathing conditions. Single-breath inert gas studies and lung function tests were performed before, immediately after, and 45 minutes after intervention. Single-breath tests assess ventilation distribution homogeneity and gas mixing by observing the extent to which an inspired test gas mixes with gas already residing in the lung. Results. Improvements in gas mixing were observed in all PEP conditions. By 45 minutes after intervention, the no-PEP group improved by 5%, the low-PEP group improved by 15%, and the high-PEP group improved by 23%. Slow vital capacity increased by 1% for no PEP, by 9% for low PEP, and by 13% for high PEP 45 minutes after intervention. Residual volume decreased by 13% after no PEP, by 20% after low PEP, and by 30% after high PEP. Immediate improvements in forced expiratory flow during the middle half of the forced vital capacity maneuver (FEF25%–75%) were sustained following high PEP but not following low PEP. Discussion and Conclusion. This study demonstrated the physiologic basis for the efficacy of PEP therapy. The results confirm that low PEP and high PEP improve gas mixing in individuals with CF, and these improvements were associated with increased lung function, sputum expectoration, and SpO2. The authors propose that improvements in gas mixing may lead to increases in oxygenation and thus functional exercise capacity.

Comparison of high‐frequency chest wall oscillation and oscillating positive expiratory pressure in the home management of cystic fibrosis: A pilot study

2001 ◽  
Vol 32 (5) ◽  
pp. 372-377 ◽  
Author(s):  
Christopher M. Oermann ◽  
Marianna M. Sockrider ◽  
Don Giles ◽  
Marci K. Sontag ◽  
Frank J. Accurso ◽  
...  
Keyword(s):  
Cystic Fibrosis ◽  
Pilot Study ◽  
Chest Wall ◽  
High Frequency ◽  
Home Management ◽  
Wall Oscillation ◽  
Positive Expiratory Pressure

scholarly journals Long-term multicentre randomised controlled study of high frequency chest wall oscillation versus positive expiratory pressure mask in cystic fibrosis

Thorax ◽  
2013 ◽  
Vol 68 (8) ◽  
pp. 746-751 ◽  
Author(s):  
Maggie Patricia McIlwaine ◽  
Nancy Alarie ◽  
George F Davidson ◽  
Larry C Lands ◽  
Felix Ratjen ◽  
...  
Keyword(s):  
Cystic Fibrosis ◽  
Chest Wall ◽  
High Frequency ◽  
Controlled Study ◽  
Randomised Controlled Study ◽  
Wall Oscillation ◽  
Randomised Controlled ◽  
Positive Expiratory Pressure

Lung pressures and gas transport during high-frequency airway and chest wall oscillation

1989 ◽  
Vol 67 (3) ◽  
pp. 985-992 ◽  
Author(s):  
M. C. Khoo ◽  
T. H. Ye ◽  
N. H. Tran
Keyword(s):  
Chest Wall ◽  
Lung Volume ◽  
High Frequency ◽  
Blood Gases ◽  
Small Degree ◽  
Conventional Mechanical Ventilation ◽  
Positive Pressure ◽  
Arterial Blood ◽  
Residual Capacity ◽  
Wall Oscillation

The major goal of this study was to compare gas exchange, tidal volume (VT), and dynamic lung pressures resulting from high-frequency airway oscillation (HFAO) with the corresponding effects in high-frequency chest wall oscillation (HFCWO). Eight anesthetized paralyzed dogs were maintained eucapnic with HFAO and HFCWO at frequencies ranging from 1 to 16 Hz in the former and 0.5 to 8 Hz in the latter. Tracheal (delta Ptr) and esophageal (delta Pes) pressure swings, VT, and arterial blood gases were measured in addition to respiratory impedance and static pressure-volume curves. Mean positive pressure (25–30 cmH2O) in the chest cuff associated with HFCWO generation decreased lung volume by approximately 200 ml and increased pulmonary impedance significantly. Aside from this decrease in functional residual capacity (FRC), no change in lung volume occurred as a result of dynamic factors during the course of HFCWO application. With HFAO, a small degree of hyperinflation occurred only at 16 Hz. Arterial PO2 decreased by 5 Torr on average during HFCWO. VT decreased with increasing frequency in both cases, but VT during HFCWO was smaller over the range of frequencies compared with HFAO. delta Pes and delta Ptr between 1 and 8 Hz were lower than the corresponding pressure swings obtained with conventional mechanical ventilation (CMV) applied at 0.25 Hz. delta Pes was minimized at 1 Hz during HFCWO; however, delta Ptr decreased continuously with decreasing frequency and, below 2 Hz, became progressively smaller than the corresponding values obtained with HFAO and CMV.

High frequency chest wall oscillation use in non-cystic fibrosis bronchiectasis: a feasibility study

2020 ◽  
Author(s):  
Giulia Cacopardo ◽  
Claudia Crimi ◽  
Raffaele Campisi ◽  
Santi Nolasco ◽  
Stefano Alia ◽  
...  
Keyword(s):  
Cystic Fibrosis ◽  
Chest Wall ◽  
Feasibility Study ◽  
High Frequency ◽  
Wall Oscillation
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