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Brian Becker - One of the best experts on this subject based on the ideXlab platform.
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The effectiveness of a mobile high‐frequency Chest Wall Oscillation (HFCWO) device for airway clearance
Pediatric pulmonology, 2020Co-Authors: Glenn Leemans, Brian Becker, Dennis Belmans, Cedric Van Holsbeke, Dirk Vissers, Kris Ides, Stijn Verhulst, Kim Van HoorenbeeckAbstract:INTRODUCTION High-frequency Chest Wall Oscillation (HFCWO) is a commonly prescribed airway clearance technique (ACT) for patients whose ability to expectorate sputum is compromised. This study aimed to assess the effectiveness of a newly developed mobile ACT device (mHFCWO-The Monarch Airway Clearance System) in patients with cystic fibrosis (CF). A standard nonmobile HFCWO device (sHFCWO) was used as a comparator. METHODOLOGY This was a randomized, open-label, crossover pilot study. CF patients were treated with each device. Sputum was collected during and after each therapy session, while spirometry tests, Brody score assessment and functional respiratory imaging were performed before and after treatments. RESULTS Wet weight of sputum collected during and after treatment was similar for mHFCWO and sHFCWO (6.53 ± 8.55 vs 5.80 ± 5.82; P = .777). Interestingly, the mHFCWO treatment led to a significant decrease in specific airway volume (9.55 ± 9.96 vs 8.74 ± 9.70 mL/L; P
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the effectiveness of a mobile high frequency Chest Wall Oscillation hfcwo device for airway clearance
Pediatric Pulmonology, 2020Co-Authors: Glenn Leemans, Brian Becker, Dennis Belmans, Cedric Van Holsbeke, Dirk Vissers, Kris Ides, Stijn Verhulst, Kim Van HoorenbeeckAbstract:INTRODUCTION High-frequency Chest Wall Oscillation (HFCWO) is a commonly prescribed airway clearance technique (ACT) for patients whose ability to expectorate sputum is compromised. This study aimed to assess the effectiveness of a newly developed mobile ACT device (mHFCWO-The Monarch Airway Clearance System) in patients with cystic fibrosis (CF). A standard nonmobile HFCWO device (sHFCWO) was used as a comparator. METHODOLOGY This was a randomized, open-label, crossover pilot study. CF patients were treated with each device. Sputum was collected during and after each therapy session, while spirometry tests, Brody score assessment and functional respiratory imaging were performed before and after treatments. RESULTS Wet weight of sputum collected during and after treatment was similar for mHFCWO and sHFCWO (6.53 ± 8.55 vs 5.80 ± 5.82; P = .777). Interestingly, the mHFCWO treatment led to a significant decrease in specific airway volume (9.55 ± 9.96 vs 8.74 ± 9.70 mL/L; P < .001), while increasing specific airway resistance (0.10 ± 0.16 vs 0.16 ± 0.23 KPA*S; P < .001). These changes were heterogeneously-distributed throughout the lung tissue and were greater in the distal areas, suggesting a shift of mucus. Changes were accompanied by an overall improvement in the Brody index (57.71 ± 16.55 vs 55.20 ± 16.98; P = .001). CONCLUSION The newly developed mobile device provides airway clearance for CF patients comparable to a nonmobile sHFCWO device, yielding a change in airway geometry and patency by the shift of mucus from the more peripheral regions to the central airways.
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Evaluation of the safety of high-frequency Chest Wall Oscillation (HFCWO) therapy in blunt thoracic trauma patients
Journal of Trauma Management & Outcomes, 2008Co-Authors: Casandra A Anderson, Brian Becker, Cassandra A Palmer, Arthur L Ney, Steven D Schaffel, Robert R QuickelAbstract:Background Airway clearance is frequently needed by patients suffering from blunt Chest Wall trauma. High Frequency Chest Wall Oscillation (HFCWO) has been shown to be effective in helping to clear secretions from the lungs of patients with cystic fibrosis, bronchiectasis, asthma, primary ciliary dyskinesia, emphysema, COPD, and many others. Chest Wall trauma patients are at increased risk for development of pulmonary complications related to airway clearance. These patients frequently have Chest tubes, drains, catheters, etc. which could become dislodged during HFCWO. This prospective observational study was conducted to determine if HFCWO treatment, as provided by The Vest™ Airway Clearance System (Hill-Rom, Saint Paul, MN), was safe and well tolerated by these patients. Methods Twenty-five blunt thoracic trauma patients were entered into the study. These patients were consented. Each patient was prescribed 2, 15 minute HFCWO treatments per day using The Vest^® Airway Clearance System (Hill-Rom, Inc., St Paul, MN). The Vest^® system was set to a frequency of 10–12 Hz and a pressure of 2–3 (arbitrary unit). Physiological parameters were measured before, during, and after treatment. Patients were free to refuse or terminate a treatment early for any reason. Results No Chest tubes, lines, drains or catheters were dislodged as a result of treatment. One patient with flail Chest had a Chest tube placed after one treatment due to increasing serous effusion. No treatments were missed and continued without further incident. Post treatment survey showed 76% experienced mild or no pain and more productive cough. Thirty days after discharge there were no deaths or hospital re-admissions. Conclusion This study suggests that HFCWO treatment is safe for trauma patients with lung and Chest Wall injuries. These findings support further work to demonstrate the airway clearance benefits of HFCWO treatment.
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Evaluation of the safety of high-frequency Chest Wall Oscillation (HFCWO) therapy in blunt thoracic trauma patients.
Journal of trauma management & outcomes, 2008Co-Authors: Casandra A Anderson, Brian Becker, Cassandra A Palmer, Arthur L Ney, Steven D Schaffel, Robert R QuickelAbstract:Airway clearance is frequently needed by patients suffering from blunt Chest Wall trauma. High Frequency Chest Wall Oscillation (HFCWO) has been shown to be effective in helping to clear secretions from the lungs of patients with cystic fibrosis, bronchiectasis, asthma, primary ciliary dyskinesia, emphysema, COPD, and many others. Chest Wall trauma patients are at increased risk for development of pulmonary complications related to airway clearance. These patients frequently have Chest tubes, drains, catheters, etc. which could become dislodged during HFCWO. This prospective observational study was conducted to determine if HFCWO treatment, as provided by The Vest™ Airway Clearance System (Hill-Rom, Saint Paul, MN), was safe and well tolerated by these patients. Twenty-five blunt thoracic trauma patients were entered into the study. These patients were consented. Each patient was prescribed 2, 15 minute HFCWO treatments per day using The Vest® Airway Clearance System (Hill-Rom, Inc., St Paul, MN). The Vest® system was set to a frequency of 10–12 Hz and a pressure of 2–3 (arbitrary unit). Physiological parameters were measured before, during, and after treatment. Patients were free to refuse or terminate a treatment early for any reason. No Chest tubes, lines, drains or catheters were dislodged as a result of treatment. One patient with flail Chest had a Chest tube placed after one treatment due to increasing serous effusion. No treatments were missed and continued without further incident. Post treatment survey showed 76% experienced mild or no pain and more productive cough. Thirty days after discharge there were no deaths or hospital re-admissions. This study suggests that HFCWO treatment is safe for trauma patients with lung and Chest Wall injuries. These findings support further work to demonstrate the airway clearance benefits of HFCWO treatment.
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Journal of Trauma Management & Outcomes BioMed Central
2008Co-Authors: Ra A Anderson, Brian Becker, Arthur L Ney, Steven D Schaffel, Robert R Quickel, Ra A PalmerAbstract:Evaluation of the safety of high-frequency Chest Wall Oscillation (HFCWO) therapy in blunt thoracic trauma patient
Robert R Quickel - One of the best experts on this subject based on the ideXlab platform.
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Evaluation of the safety of high-frequency Chest Wall Oscillation (HFCWO) therapy in blunt thoracic trauma patients
Journal of Trauma Management & Outcomes, 2008Co-Authors: Casandra A Anderson, Brian Becker, Cassandra A Palmer, Arthur L Ney, Steven D Schaffel, Robert R QuickelAbstract:Background Airway clearance is frequently needed by patients suffering from blunt Chest Wall trauma. High Frequency Chest Wall Oscillation (HFCWO) has been shown to be effective in helping to clear secretions from the lungs of patients with cystic fibrosis, bronchiectasis, asthma, primary ciliary dyskinesia, emphysema, COPD, and many others. Chest Wall trauma patients are at increased risk for development of pulmonary complications related to airway clearance. These patients frequently have Chest tubes, drains, catheters, etc. which could become dislodged during HFCWO. This prospective observational study was conducted to determine if HFCWO treatment, as provided by The Vest™ Airway Clearance System (Hill-Rom, Saint Paul, MN), was safe and well tolerated by these patients. Methods Twenty-five blunt thoracic trauma patients were entered into the study. These patients were consented. Each patient was prescribed 2, 15 minute HFCWO treatments per day using The Vest^® Airway Clearance System (Hill-Rom, Inc., St Paul, MN). The Vest^® system was set to a frequency of 10–12 Hz and a pressure of 2–3 (arbitrary unit). Physiological parameters were measured before, during, and after treatment. Patients were free to refuse or terminate a treatment early for any reason. Results No Chest tubes, lines, drains or catheters were dislodged as a result of treatment. One patient with flail Chest had a Chest tube placed after one treatment due to increasing serous effusion. No treatments were missed and continued without further incident. Post treatment survey showed 76% experienced mild or no pain and more productive cough. Thirty days after discharge there were no deaths or hospital re-admissions. Conclusion This study suggests that HFCWO treatment is safe for trauma patients with lung and Chest Wall injuries. These findings support further work to demonstrate the airway clearance benefits of HFCWO treatment.
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Evaluation of the safety of high-frequency Chest Wall Oscillation (HFCWO) therapy in blunt thoracic trauma patients.
Journal of trauma management & outcomes, 2008Co-Authors: Casandra A Anderson, Brian Becker, Cassandra A Palmer, Arthur L Ney, Steven D Schaffel, Robert R QuickelAbstract:Airway clearance is frequently needed by patients suffering from blunt Chest Wall trauma. High Frequency Chest Wall Oscillation (HFCWO) has been shown to be effective in helping to clear secretions from the lungs of patients with cystic fibrosis, bronchiectasis, asthma, primary ciliary dyskinesia, emphysema, COPD, and many others. Chest Wall trauma patients are at increased risk for development of pulmonary complications related to airway clearance. These patients frequently have Chest tubes, drains, catheters, etc. which could become dislodged during HFCWO. This prospective observational study was conducted to determine if HFCWO treatment, as provided by The Vest™ Airway Clearance System (Hill-Rom, Saint Paul, MN), was safe and well tolerated by these patients. Twenty-five blunt thoracic trauma patients were entered into the study. These patients were consented. Each patient was prescribed 2, 15 minute HFCWO treatments per day using The Vest® Airway Clearance System (Hill-Rom, Inc., St Paul, MN). The Vest® system was set to a frequency of 10–12 Hz and a pressure of 2–3 (arbitrary unit). Physiological parameters were measured before, during, and after treatment. Patients were free to refuse or terminate a treatment early for any reason. No Chest tubes, lines, drains or catheters were dislodged as a result of treatment. One patient with flail Chest had a Chest tube placed after one treatment due to increasing serous effusion. No treatments were missed and continued without further incident. Post treatment survey showed 76% experienced mild or no pain and more productive cough. Thirty days after discharge there were no deaths or hospital re-admissions. This study suggests that HFCWO treatment is safe for trauma patients with lung and Chest Wall injuries. These findings support further work to demonstrate the airway clearance benefits of HFCWO treatment.
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Journal of Trauma Management & Outcomes BioMed Central
2008Co-Authors: Ra A Anderson, Brian Becker, Arthur L Ney, Steven D Schaffel, Robert R Quickel, Ra A PalmerAbstract:Evaluation of the safety of high-frequency Chest Wall Oscillation (HFCWO) therapy in blunt thoracic trauma patient
Antonello Nicolini - One of the best experts on this subject based on the ideXlab platform.
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Effectiveness of two high frequency Chest Wall Oscillation techniques in patients with bronchiectasis: a randomized controlled preliminary study.
Panminerva medica, 2020Co-Authors: Antonello Nicolini, Bruna Grecchi, Paolo BanfiAbstract:Background Chest physiotherapy is an important tool in the treatment of bronchiectasis. High frequency Chest Wall Oscillation (HFCWO) is a technique designed to create a global percussion of the lung which moves secretions and probably clears the peripheral bronchial tree. We propose the comparison between an existing device (SmartVest) and a new device (RespIn 11). Methods Sixty patients were randomized into three groups: a group was treated with SmartVest, a group with RespIn 11, and a group with pharmacological therapy alone. Primary outcome measures included exacerbations at 3, 6 and 12 months after the end of treatment. Secondary outcome measures were pulmonary function testing, arterial blood gas analysis (ABG), and hematological examinations, cough, dyspnea, health and quality of life scores (Bronchiectasis Health Questionnaire [BHQ], Breathlessness, Cough, and Sputum Scale [BCSS], COPD Assessment Test [CAT], Leicester Cough Questionnaire [LCT]). A 5-point Likert scale was used to evaluate patient's preference. Results Both patients in the HFCWO groups showed a significant improvement in the tests of dyspnea, cough and health and quality of life score evaluations (BHQ, BCSS, CAT, LCT) compared to the control group, but not in pulmonary function tests and ABG. Only RespIn 11 significantly reduced exacerbations in comparison with the control group. RespIn 11 also had a higher score regarding patients' preference. Conclusions The two machines have improved health and quality of life scores in patients with bronchiectasis. RespIn 11 also demonstrated a significant lowering of exacerbations and a better patient acceptance.
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Short-term comparative and follow-up study of two high frequency Chest Wall Oscillation techniques in patients with bronchiectasis : a preliminary study
Rehabilitation and chronic care, 2019Co-Authors: Antonello Nicolini, Bruna GrecchiAbstract:Purpose: Chest physiotherapy is an important tool in the treatment of bronchiectasis. High frequency Chest Wall Oscillation (HFCWO) is techniques designed to create a global percussion of the lung which removes secretions and probably clears the peripheral bronchial tree. We purpose the comparison between a existing machine ( SmartVest ) and a novel machine ( RespIn 11). Methods: Sixty patients were randomized to three groups : a group was treated with SmartVest, a group with RespIn 11 and a group with pharmacological therapy alone. Primary outcome measures included exacerbations 3,6 and 12 months after the end of treatment. Secondary outcome measures were pulmonary function testing, arterial blood gas analysis(ABG), and hematological examinations, cough, dyspnea, health and quality of life scores ( Bronchiectasis Health Questionnaire[BHQ], Breathlessness, Cough, and Sputum Scale[BCSS], COPD Assessment Test[CAT], Leicester Cough Questionnaire[LCT] ).A 5-point Likert scale was used to evaluate patients preference. Results: Both patients in the HFCWO groups showed a significant improvement in the tests of dyspnea, cough and health and quality of life score evaluations (BHQ, BCSS, CAT, LCT) compared to the control group, but not in pulmonary function tests and ABG. Only RespIn 11 reduced exacerbations in comparison with control group. RespIn 11 had a greater score regarding patients preference. Conclusions: The two machines improve health and quality of life scores in patients with bronchiectasis. RespIn 11 demonstrated also a significant lowering of exacerbations and a better acceptance.
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Safety and effectiveness of the high-frequency Chest Wall Oscillation vs intrapulmonary percussive ventilation in patients with severe COPD.
International journal of chronic obstructive pulmonary disease, 2018Co-Authors: Antonello Nicolini, Bruna Grecchi, Maura Ferrari-bravo, Cornelius BarlasciniAbstract:Purpose Chest physiotherapy is an important tool in the treatment of COPD. Intrapulmonary percussive ventilation (IPV) and high-frequency Chest Wall Oscillation (HFCWO) are techniques designed to create a global percussion of the lung which removes secretions and probably clears the peripheral bronchial tree. We tested the hypothesis that adding IPV or HFCWO to the best pharmacological therapy (PT) may provide additional clinical benefit over Chest physiotherapy in patients with severe COPD. Methods Sixty patients were randomized into three groups (20 patients in each group): IPV group (treated with PT and IPV), PT group with (treated with PT and HFCWO), and control group (treated with PT alone). Primary outcome measures included results on the dyspnea scale (modified Medical Research Council) and Breathlessness, Cough, and Sputum scale (BCSS), as well as an evaluation of daily life activity (COPD Assessment Test [CAT]). Secondary outcome measures were pulmonary function testing, arterial blood gas analysis, and hematological examinations. Moreover, sputum cell counts were performed at the beginning and at the end of the study. Results Patients in both the IPV group and the HFCWO group showed a significant improvement in the tests of dyspnea and daily life activity evaluations (modified Medical Research Council scale, BCSS, and CAT) compared to the control group, as well as in pulmonary function tests (forced vital capacity, forced expiratory volume in 1 second, forced expiratory volume in 1 second/forced vital capacity%, total lung capacity, residual volume, diffusing lung capacity monoxide, maximal inspiratory pressure, maximal expiratory pressure) and arterial blood gas values. However, in the group comparison analysis for the same variables between IPV group and HFCWO group, we observed a significant improvement in the IPV group maximal inspiratory pressure, maximal expiratory pressure, BCSS, and CAT. Similar results were observed in changes of sputum cytology with reduction of inflammatory cells (neutrophils and macrophages). Conclusion The two techniques improved daily life activities and lung function in patients with severe COPD. IPV demonstrated a significantly greater effectiveness in improving some pulmonary function tests linked to the small bronchial airways obstruction and respiratory muscle strength and scores on health status assessment scales (BCSS and CAT) as well as a reduction of sputum inflammatory cells compared with HFCWO.
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Safety and effectiveness of the high-frequency Chest Wall Oscillation vs intrapulmonary percussive ventilation in patients with severe COPD
International Journal of Chronic Obstructive Pulmonary Disease, 2018Co-Authors: Antonello Nicolini, Bruna Grecchi, Maura Ferrari-bravo, Cornelius BarlasciniAbstract:Antonello Nicolini,1 Bruna Grecchi,2 Maura Ferrari-Bravo,3 Cornelius Barlascini4 1Respiratory Diseases Unit, Hospital of Sestri Levante, Sestri Levante, Italy; 2Rehabilitation Unit, ASL4 Chiavarese, Chiavari, Italy; 3Statistics Unit, ASL4 Chiavarese, Chiavari, Italy; 4Health Medicine Unit, Hospital of Sestri Levante, Sestri Levante, Italy Purpose: Chest physiotherapy is an important tool in the treatment of COPD. Intrapulmonary percussive ventilation (IPV) and high-frequency Chest Wall Oscillation (HFCWO) are techniques designed to create a global percussion of the lung which removes secretions and probably clears the peripheral bronchial tree. We tested the hypothesis that adding IPV or HFCWO to the best pharmacological therapy (PT) may provide additional clinical benefit over Chest physiotherapy in patients with severe COPD. Methods: Sixty patients were randomized into three groups (20 patients in each group): IPV group (treated with PT and IPV), PT group with (treated with PT and HFCWO), and control group (treated with PT alone). Primary outcome measures included results on the dyspnea scale (modified Medical Research Council) and Breathlessness, Cough, and Sputum scale (BCSS), as well as an evaluation of daily life activity (COPD Assessment Test [CAT]). Secondary outcome measures were pulmonary function testing, arterial blood gas analysis, and hematological examinations. Moreover, sputum cell counts were performed at the beginning and at the end of the study. Results: Patients in both the IPV group and the HFCWO group showed a significant improvement in the tests of dyspnea and daily life activity evaluations (modified Medical Research Council scale, BCSS, and CAT) compared to the control group, as well as in pulmonary function tests (forced vital capacity, forced expiratory volume in 1 second, forced expiratory volume in 1 second/forced vital capacity%, total lung capacity, residual volume, diffusing lung capacity monoxide, maximal inspiratory pressure, maximal expiratory pressure) and arterial blood gas values. However, in the group comparison analysis for the same variables between IPV group and HFCWO group, we observed a significant improvement in the IPV group maximal inspiratory pressure, maximal expiratory pressure, BCSS, and CAT. Similar results were observed in changes of sputum cytology with reduction of inflammatory cells (neutrophils and macrophages). Conclusion: The two techniques improved daily life activities and lung function in patients with severe COPD. IPV demonstrated a significantly greater effectiveness in improving some pulmonary function tests linked to the small bronchial airways obstruction and respiratory muscle strength and scores on health status assessment scales (BCSS and CAT) as well as a reduction of sputum inflammatory cells compared with HFCWO. Keywords: severe COPD, intrapulmonary percussive ventilation, high-frequency Chest Wall Oscillation, daily life activit
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Comparison of intrapulmonary percussive ventilation and high frequency Chest Wall Oscillation in patients with severe COPD
European Respiratory Journal, 2014Co-Authors: Davide Russo, Bruna Grecchi, Christopher Romaggi, Antonello NicoliniAbstract:Background We test the hypothesis that adding IPV or HFCWO to the best pharmacological therapy (PT) may provide additional clinical benefit over PT in patients with severe COPD. Methods Sixty patients were randomized to three groups ( 20 patients in each group) : a group was treated with PT and IPV, a group with PT and HFCWO and a group with PT alone.Primary outcome measures included dyspnea scale (MMRC),breathlessness, cough, and sputum scales, as well as daily life activity evaluations (CAT, BCSS). Secondary outcome measures were pulmonary function testing, arterial blood gas analysis (ABG), and hematological examinations. Results Both patients in the IPV group and in the HFCWO group showed a significant improvement in the tests of dyspnea and quality of life assessment (MMRC, BCSS,CAT) compared to the control group, as well as in pulmonary function tests and ABG. However, in the group comparison analysis for the same variables between IPV group and HFCWO group we observed a significant improvement in the IPV group MIP, MEP (p≤0.01) and BCSS (p≤ 0.001), CAT (p≤ 0.02). Discussion The two techniques improve the quality of life and lung function in patients with severe COPD. IPV demonstrated a significant greater effectiveness in improving some pulmonary function tests linked to the respiratory muscle strength and quality of life tools (BCSS,CAT) than HFCWO.
Cornelius Barlascini - One of the best experts on this subject based on the ideXlab platform.
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Safety and effectiveness of the high-frequency Chest Wall Oscillation vs intrapulmonary percussive ventilation in patients with severe COPD.
International journal of chronic obstructive pulmonary disease, 2018Co-Authors: Antonello Nicolini, Bruna Grecchi, Maura Ferrari-bravo, Cornelius BarlasciniAbstract:Purpose Chest physiotherapy is an important tool in the treatment of COPD. Intrapulmonary percussive ventilation (IPV) and high-frequency Chest Wall Oscillation (HFCWO) are techniques designed to create a global percussion of the lung which removes secretions and probably clears the peripheral bronchial tree. We tested the hypothesis that adding IPV or HFCWO to the best pharmacological therapy (PT) may provide additional clinical benefit over Chest physiotherapy in patients with severe COPD. Methods Sixty patients were randomized into three groups (20 patients in each group): IPV group (treated with PT and IPV), PT group with (treated with PT and HFCWO), and control group (treated with PT alone). Primary outcome measures included results on the dyspnea scale (modified Medical Research Council) and Breathlessness, Cough, and Sputum scale (BCSS), as well as an evaluation of daily life activity (COPD Assessment Test [CAT]). Secondary outcome measures were pulmonary function testing, arterial blood gas analysis, and hematological examinations. Moreover, sputum cell counts were performed at the beginning and at the end of the study. Results Patients in both the IPV group and the HFCWO group showed a significant improvement in the tests of dyspnea and daily life activity evaluations (modified Medical Research Council scale, BCSS, and CAT) compared to the control group, as well as in pulmonary function tests (forced vital capacity, forced expiratory volume in 1 second, forced expiratory volume in 1 second/forced vital capacity%, total lung capacity, residual volume, diffusing lung capacity monoxide, maximal inspiratory pressure, maximal expiratory pressure) and arterial blood gas values. However, in the group comparison analysis for the same variables between IPV group and HFCWO group, we observed a significant improvement in the IPV group maximal inspiratory pressure, maximal expiratory pressure, BCSS, and CAT. Similar results were observed in changes of sputum cytology with reduction of inflammatory cells (neutrophils and macrophages). Conclusion The two techniques improved daily life activities and lung function in patients with severe COPD. IPV demonstrated a significantly greater effectiveness in improving some pulmonary function tests linked to the small bronchial airways obstruction and respiratory muscle strength and scores on health status assessment scales (BCSS and CAT) as well as a reduction of sputum inflammatory cells compared with HFCWO.
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Safety and effectiveness of the high-frequency Chest Wall Oscillation vs intrapulmonary percussive ventilation in patients with severe COPD
International Journal of Chronic Obstructive Pulmonary Disease, 2018Co-Authors: Antonello Nicolini, Bruna Grecchi, Maura Ferrari-bravo, Cornelius BarlasciniAbstract:Antonello Nicolini,1 Bruna Grecchi,2 Maura Ferrari-Bravo,3 Cornelius Barlascini4 1Respiratory Diseases Unit, Hospital of Sestri Levante, Sestri Levante, Italy; 2Rehabilitation Unit, ASL4 Chiavarese, Chiavari, Italy; 3Statistics Unit, ASL4 Chiavarese, Chiavari, Italy; 4Health Medicine Unit, Hospital of Sestri Levante, Sestri Levante, Italy Purpose: Chest physiotherapy is an important tool in the treatment of COPD. Intrapulmonary percussive ventilation (IPV) and high-frequency Chest Wall Oscillation (HFCWO) are techniques designed to create a global percussion of the lung which removes secretions and probably clears the peripheral bronchial tree. We tested the hypothesis that adding IPV or HFCWO to the best pharmacological therapy (PT) may provide additional clinical benefit over Chest physiotherapy in patients with severe COPD. Methods: Sixty patients were randomized into three groups (20 patients in each group): IPV group (treated with PT and IPV), PT group with (treated with PT and HFCWO), and control group (treated with PT alone). Primary outcome measures included results on the dyspnea scale (modified Medical Research Council) and Breathlessness, Cough, and Sputum scale (BCSS), as well as an evaluation of daily life activity (COPD Assessment Test [CAT]). Secondary outcome measures were pulmonary function testing, arterial blood gas analysis, and hematological examinations. Moreover, sputum cell counts were performed at the beginning and at the end of the study. Results: Patients in both the IPV group and the HFCWO group showed a significant improvement in the tests of dyspnea and daily life activity evaluations (modified Medical Research Council scale, BCSS, and CAT) compared to the control group, as well as in pulmonary function tests (forced vital capacity, forced expiratory volume in 1 second, forced expiratory volume in 1 second/forced vital capacity%, total lung capacity, residual volume, diffusing lung capacity monoxide, maximal inspiratory pressure, maximal expiratory pressure) and arterial blood gas values. However, in the group comparison analysis for the same variables between IPV group and HFCWO group, we observed a significant improvement in the IPV group maximal inspiratory pressure, maximal expiratory pressure, BCSS, and CAT. Similar results were observed in changes of sputum cytology with reduction of inflammatory cells (neutrophils and macrophages). Conclusion: The two techniques improved daily life activities and lung function in patients with severe COPD. IPV demonstrated a significantly greater effectiveness in improving some pulmonary function tests linked to the small bronchial airways obstruction and respiratory muscle strength and scores on health status assessment scales (BCSS and CAT) as well as a reduction of sputum inflammatory cells compared with HFCWO. Keywords: severe COPD, intrapulmonary percussive ventilation, high-frequency Chest Wall Oscillation, daily life activit
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Effectiveness of treatment with high-frequency Chest Wall Oscillation in patients with bronchiectasis
BMC Pulmonary Medicine, 2013Co-Authors: Antonello Nicolini, Maura Ferrari-bravo, Federica Cardini, Norma Landucci, Sergio Lanata, Cornelius BarlasciniAbstract:Background High-frequency airway clearance (HFCWC) assist devices generate either positive or negative trans-respiratory pressure excursions to produce high-frequency, small-volume Oscillations in the airways. HFCWC can lead to changes in volume of 15–57 ml and in flow up to 1.6 L/s, which generate minimal coughing to mobilize secretions. The typical treatment lasts 20–30 minutes, and consists of short periods of compression at different frequencies, separated by coughing. The aim of this study was to find the more efficacious treatment in patients with bronchiectasis: traditional techniques of Chest physiotherapy (CPT) versus high frequency Oscillation of the Chest Wall in patients with bronchiectasis. Methods 37 patients were enrolled. Seven of them were excluded. Computer randomization divided the patients into three groups: 10 patients treated with HFCWO by using the Vest® Airway Clearance System; 10 patients treated with traditional techniques of air way clearance (PEP bottle, PEP mask, ELTGOL, vibratory positive expiratory pressure); 10 patients received medical therapy only (control group). To be eligible for enrollment, participants had to be between 18 and 85 years old and have a diagnosis of bronchiectasis, confirmed on high resolution computed tomography. Exclusion criteria: lack of informed consent, signs of exacerbation, cystic fibrosis. Before the treatment, each patient had blood tests, sputum volume and cell count, pulmonary function tests and on the quality of life inventories (MMRC, CAT, BCSS). The results were processed through the covariance analysis, performed with the R-Project statistical program. It has been considered a positive result p
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Effectiveness of treatment with high-frequency Chest Wall Oscillation in patients with bronchiectasis
BMC pulmonary medicine, 2013Co-Authors: Antonello Nicolini, Maura Ferrari-bravo, Federica Cardini, Norma Landucci, Sergio Lanata, Cornelius BarlasciniAbstract:High-frequency airway clearance (HFCWC) assist devices generate either positive or negative trans-respiratory pressure excursions to produce high-frequency, small-volume Oscillations in the airways. HFCWC can lead to changes in volume of 15–57 ml and in flow up to 1.6 L/s, which generate minimal coughing to mobilize secretions. The typical treatment lasts 20–30 minutes, and consists of short periods of compression at different frequencies, separated by coughing. The aim of this study was to find the more efficacious treatment in patients with bronchiectasis: traditional techniques of Chest physiotherapy (CPT) versus high frequency Oscillation of the Chest Wall in patients with bronchiectasis. 37 patients were enrolled. Seven of them were excluded. Computer randomization divided the patients into three groups: To be eligible for enrollment, participants had to be between 18 and 85 years old and have a diagnosis of bronchiectasis, confirmed on high resolution computed tomography. Exclusion criteria: lack of informed consent, signs of exacerbation, cystic fibrosis. Before the treatment, each patient had blood tests, sputum volume and cell count, pulmonary function tests and on the quality of life inventories (MMRC, CAT, BCSS). The results were processed through the covariance analysis, performed with the R-Project statistical program. It has been considered a positive result p
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effectiveness of treatment with high frequency Chest Wall Oscillation in patients with bronchiectasis
BMC Pulmonary Medicine, 2013Co-Authors: Antonello Nicolini, Federica Cardini, Norma Landucci, Sergio Lanata, Maura Ferraribravo, Cornelius BarlasciniAbstract:High-frequency airway clearance (HFCWC) assist devices generate either positive or negative trans-respiratory pressure excursions to produce high-frequency, small-volume Oscillations in the airways. HFCWC can lead to changes in volume of 15–57 ml and in flow up to 1.6 L/s, which generate minimal coughing to mobilize secretions. The typical treatment lasts 20–30 minutes, and consists of short periods of compression at different frequencies, separated by coughing. The aim of this study was to find the more efficacious treatment in patients with bronchiectasis: traditional techniques of Chest physiotherapy (CPT) versus high frequency Oscillation of the Chest Wall in patients with bronchiectasis. 37 patients were enrolled. Seven of them were excluded. Computer randomization divided the patients into three groups: To be eligible for enrollment, participants had to be between 18 and 85 years old and have a diagnosis of bronchiectasis, confirmed on high resolution computed tomography. Exclusion criteria: lack of informed consent, signs of exacerbation, cystic fibrosis. Before the treatment, each patient had blood tests, sputum volume and cell count, pulmonary function tests and on the quality of life inventories (MMRC, CAT, BCSS). The results were processed through the covariance analysis, performed with the R-Project statistical program. It has been considered a positive result p <005. Both treatments (traditional CPT and HFCWO) showed a significant improvement in some biochemical and functional respiratory tests as well as in the quality of life compared to the control group. The use of HFCWO compared to CPT also produced a significant improvement in blood inflammation parameter C-RP (p ≤0.019), parameters of lung functionality associated with bronchial obstruction (FVC, FEV1) (p ≤0.006 and p ≤0.001), and in the dyspnea. Improvement in quality of life scales was noted. (BCSS, CAT) (both p ≤0.001). No significant changes of total cell counts in sputum samples were observed in the two groups. In the HFCWO group a significant reduction of neutrophils percentage (p≤0.002) and a significant increase of macrophages percentage (p ≤0.012). The HFCWO technique provides an improvement both in pulmonary function and quality of life related parameters in patients with chronic hypersecretive disease. Since those patients need daily airway clearance, this treatment should be included among the principal options in Chest physiotherapy. The study was registered as ChiCTR-TRC-12002134 at http://www.chictr.org .
Steven D Schaffel - One of the best experts on this subject based on the ideXlab platform.
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Evaluation of the safety of high-frequency Chest Wall Oscillation (HFCWO) therapy in blunt thoracic trauma patients
Journal of Trauma Management & Outcomes, 2008Co-Authors: Casandra A Anderson, Brian Becker, Cassandra A Palmer, Arthur L Ney, Steven D Schaffel, Robert R QuickelAbstract:Background Airway clearance is frequently needed by patients suffering from blunt Chest Wall trauma. High Frequency Chest Wall Oscillation (HFCWO) has been shown to be effective in helping to clear secretions from the lungs of patients with cystic fibrosis, bronchiectasis, asthma, primary ciliary dyskinesia, emphysema, COPD, and many others. Chest Wall trauma patients are at increased risk for development of pulmonary complications related to airway clearance. These patients frequently have Chest tubes, drains, catheters, etc. which could become dislodged during HFCWO. This prospective observational study was conducted to determine if HFCWO treatment, as provided by The Vest™ Airway Clearance System (Hill-Rom, Saint Paul, MN), was safe and well tolerated by these patients. Methods Twenty-five blunt thoracic trauma patients were entered into the study. These patients were consented. Each patient was prescribed 2, 15 minute HFCWO treatments per day using The Vest^® Airway Clearance System (Hill-Rom, Inc., St Paul, MN). The Vest^® system was set to a frequency of 10–12 Hz and a pressure of 2–3 (arbitrary unit). Physiological parameters were measured before, during, and after treatment. Patients were free to refuse or terminate a treatment early for any reason. Results No Chest tubes, lines, drains or catheters were dislodged as a result of treatment. One patient with flail Chest had a Chest tube placed after one treatment due to increasing serous effusion. No treatments were missed and continued without further incident. Post treatment survey showed 76% experienced mild or no pain and more productive cough. Thirty days after discharge there were no deaths or hospital re-admissions. Conclusion This study suggests that HFCWO treatment is safe for trauma patients with lung and Chest Wall injuries. These findings support further work to demonstrate the airway clearance benefits of HFCWO treatment.
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Evaluation of the safety of high-frequency Chest Wall Oscillation (HFCWO) therapy in blunt thoracic trauma patients.
Journal of trauma management & outcomes, 2008Co-Authors: Casandra A Anderson, Brian Becker, Cassandra A Palmer, Arthur L Ney, Steven D Schaffel, Robert R QuickelAbstract:Airway clearance is frequently needed by patients suffering from blunt Chest Wall trauma. High Frequency Chest Wall Oscillation (HFCWO) has been shown to be effective in helping to clear secretions from the lungs of patients with cystic fibrosis, bronchiectasis, asthma, primary ciliary dyskinesia, emphysema, COPD, and many others. Chest Wall trauma patients are at increased risk for development of pulmonary complications related to airway clearance. These patients frequently have Chest tubes, drains, catheters, etc. which could become dislodged during HFCWO. This prospective observational study was conducted to determine if HFCWO treatment, as provided by The Vest™ Airway Clearance System (Hill-Rom, Saint Paul, MN), was safe and well tolerated by these patients. Twenty-five blunt thoracic trauma patients were entered into the study. These patients were consented. Each patient was prescribed 2, 15 minute HFCWO treatments per day using The Vest® Airway Clearance System (Hill-Rom, Inc., St Paul, MN). The Vest® system was set to a frequency of 10–12 Hz and a pressure of 2–3 (arbitrary unit). Physiological parameters were measured before, during, and after treatment. Patients were free to refuse or terminate a treatment early for any reason. No Chest tubes, lines, drains or catheters were dislodged as a result of treatment. One patient with flail Chest had a Chest tube placed after one treatment due to increasing serous effusion. No treatments were missed and continued without further incident. Post treatment survey showed 76% experienced mild or no pain and more productive cough. Thirty days after discharge there were no deaths or hospital re-admissions. This study suggests that HFCWO treatment is safe for trauma patients with lung and Chest Wall injuries. These findings support further work to demonstrate the airway clearance benefits of HFCWO treatment.
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Journal of Trauma Management & Outcomes BioMed Central
2008Co-Authors: Ra A Anderson, Brian Becker, Arthur L Ney, Steven D Schaffel, Robert R Quickel, Ra A PalmerAbstract:Evaluation of the safety of high-frequency Chest Wall Oscillation (HFCWO) therapy in blunt thoracic trauma patient