11-2 High Frequency Chest Wall Oscillation

High Frequency Chest Wall Oscillation: An airway clearance technique to improve the lives of individuals with chronic hypersecretory lung disease
Jan Stephen Tecklin, P.T., M.Sc.

Abstract

Airway clearance (AC), formerly called chest physiotherapy, include numerous techniques and devices to clear airways of retained secretions in individuals with pulmonary disease or respiratory impairment. Approaches to AC include manual techniques, various mechanical devices, and instruction in selected breathing methods all in an effort to clear the airways of secretions. AC is used universally for individuals with cystic fibrosis, patients with various neuromuscular disorders such as amyotrophic lateral sclerosis, but less commonly for people with chronic obstructive pulmonary disease with mucus hypersecretion. This paper describes a newer AC technique called high frequency chest wall oscillation that uses an air-pulse generator and a vest-like garment. An evidence-based physiological rationale is cited for the several benefits for this AC approach. Numerous support references are also included. High frequency chest wall oscillation has become popular in the United States and is gaining popularity throughout Europe. There is a growing body of evidence to support it efficacy, safety, and acceptance for individuals with both acute and chronic secretion retention secondary to pulmonary disorders or other problems that lead to secretion retention.

Key words: airway clearance, cystic fibrosis, chronic obstructive lung disease, high frequency chest wall oscillations.