Clinical Implications High Frequency Chest Wall Oscillation (HFCWO)

Purpose: patients with neuromuscular diseases presents an high incidence of respiratory infections favoured by stagnation of deep bronchial secretions and deficit of cough. The aim of the study is to evaluate the correct treatment of this condition and the role of High Frequency Chest Wall Oscillation (HFCWO) in helping the removal of bronchial secretions and reduce the incidence of infections in patients with neuromuscular disease. Methods: analysis of the current bibliography related to respiratory infections and neuromuscular disease. PCEF (Peak Cough Expiratory Flow) is used as a standardized indicator of efficiency of cough. Results: the High Frequency Chest Wall Oscillation (HFCWO) is useful, in cases of increased production of mucus and impairment of muco-ciliary clearance, to remove the tracheobronchial secretions and reduce the incidence of infections. Conclusions: the correct approach to patients with neuromuscular disease and frequent respiratory infections is focused on treatment of cough ineffective and management of bronchial secretions. High Frequency Chest Wall Oscillation (HFCWO) (VEST) has a central role in treatment of cough ineffective and management of bronchial secretions reducing respiratory infections.

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Secretion management in the mechanically ventilated patient

Working Paper of Public Health ◽

10.4081/wpph.2012.6783 ◽

2012 ◽

Vol 1 (1) ◽

Author(s):

E. Mantellini ◽

L. Perrero ◽

G. Provenzano ◽

S. Petrozzino

Keyword(s):

Mechanical Ventilation ◽

Chest Wall ◽

High Frequency ◽

Pulmonary Infection ◽

Respiratory Infections ◽

Bronchial Secretion ◽

Mechanically Ventilated ◽

Bronchial Secretions ◽

Wall Oscillation

Purpose: the aim of this work is to highlight the importance of a correct management of the secretions in the patient submitted to mechanical ventilation (MV). Methods: analysis of the current bibliography related to respiratory infections and secretion in patients with mechanically ventilation. We focus on the use of in-ex suflator achine (cough machine) associated with High Frequency Chest Wall Oscillation (HFCWO). Results: we observe a reduction of pulmonary infection and a better management of bronchial secretion in patient undergone to the use of in-ex suflator machine (cough machine) associated with High Frequency Chest Wall Oscillation (HFCWO). Conclusions: the correct approach to patients submitted to mechanical ventilation (MV) expect the use of High Frequency Chest Wall Oscillation (HFCWO) (VEST) and in-ex suflator machine (cough machine) to decrease pulmonary infection thank to a reduction of permanence of bronchial secretions in the lungs.

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Correspondence on ‘‘Safety, Tolerability, and Efficacy of High-Frequency Chest Wall Oscillation in Pediatric Patients With Cerebral Palsy and Neuromuscular Diseases: An Exploratory Randomized Controlled Trial’’

Journal of Child Neurology ◽

10.1177/0883073810384614 ◽

2010 ◽

Vol 25 (12) ◽

pp. 1598-1598

Author(s):

Audrius V. Plioplys

Keyword(s):

Randomized Controlled Trial ◽

Cerebral Palsy ◽

Chest Wall ◽

High Frequency ◽

Pediatric Patients ◽

Controlled Trial ◽

Neuromuscular Diseases ◽

Randomized Controlled ◽

Wall Oscillation

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Response to Correspondence on ‘‘Safety, Tolerability, and Efficacy of High-Frequency Chest Wall Oscillation in Pediatric Patients With Cerebral Palsy and Neuromuscular Diseases: An Exploratory Randomized Controlled Trial’’

Journal of Child Neurology ◽

10.1177/0883073810385117 ◽

2010 ◽

Vol 25 (12) ◽

pp. 1598-1598 ◽

Cited By ~ 1

Author(s):

Nanci Yuan

Keyword(s):

Randomized Controlled Trial ◽

Cerebral Palsy ◽

Chest Wall ◽

High Frequency ◽

Pediatric Patients ◽

Controlled Trial ◽

Neuromuscular Diseases ◽

Randomized Controlled ◽

Wall Oscillation

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All You Need Is Evidence: What We Know About Pneumonia in Children With Neuromuscular Diseases

Frontiers in Pediatrics ◽

10.3389/fped.2021.625751 ◽

2021 ◽

Vol 9 ◽

Author(s):

Claudio Cherchi ◽

Maria B. Chiarini Testa ◽

Daniele Deriu ◽

Alessandra Schiavino ◽

Francesca Petreschi ◽

...

Keyword(s):

Neuromuscular Disease ◽

Respiratory Infections ◽

Neuromuscular Diseases ◽

Respiratory Muscles ◽

Upper Respiratory Tract ◽

Respiratory Complications ◽

Bronchial Secretions ◽

Upper Respiratory ◽

Viral Respiratory Infections ◽

Viral Respiratory

Neuromuscular diseases may involve all major respiratory muscles groups including inspiratory, expiratory, and bulbar muscles. Respiratory complications are the major cause of morbidity and mortality. Pneumonia represents a frequent cause of morbidity in children with neuromuscular disease. The aim of this review is to collect knowledge about pneumonia in children with neuromuscular diseases. Pneumonia usually follows viral respiratory infections of the upper respiratory tract, due to the combination of an increased amount of nasal and oral secretions and an impairment of the cough efficiency and of the clearance of secretions due to the muscle weakness, further compromised by the infection itself. The accumulation of bronchial secretions leads to atelectasis and promote bacterial infection. Moreover, dysfunction of swallowing mechanism exposes these children to the risk of developing aspiration pneumonia. However, etiology of viral and bacterial respiratory infection in these patients is still poorly studied.

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