Effect of high-frequency oral airway and chest wall oscillation and conventional chest physical therapy on expectoration in patients with stable cystic fibrosis

Thomas A. Scherer, Jürg Barandun, Elena Martinez, Adam Wanner, Eben M. Rubin

Research output: Contribution to journalArticle

55 Citations (Scopus)

Abstract

Study objective: To compare the effect of high-frequency oral airway oscillation, high-frequency chest wall oscillation, and conventional chest physical therapy (CPT) on weight of expectorated sputum, pulmonary function, and oxygen saturation in outpatients with stable cystic fibrosis (CF). Design: Prospective randomized trial. Setting: Pediatric pulmonary division of a tertiary care center. Patients: Fourteen outpatients with stable CF recruited from the CF center. Interventions: Two modes of oral airway oscillation (1: frequency 8 Hz; inspiratory to expiratory [I:E] ratio 9:1; 2: frequency 14 Hz; I:E ratio 8:1), two modes of chest wall oscillation (1: frequency 3 Hz; I:E ratio 4:1; 2: frequency 16 Hz; I:E ratio 1:1, alternating with frequency 1.5 Hz, I:E ratio 6:1), and CPT (clapping, vibration, postural drainage, and encouraged coughing) were applied during the first 20 min of 4 consecutive hours. Measurements and results: Sputum was collected on an hourly basis for a total of 6 consecutive hours. During the first and the last hour, patients collected sputum without having any treatment and underwent pulmonary function tests (PFTs). Oxygen saturation was measured at 30-min intervals during hours 1 to 6. For the first 20 min of the second to the fifth hour, patients received one of the treatments. To assess the effect of the intervention, the weight of expectorated sputum during hours 2 to 6 was averaged and expressed as percentage of the weight expectorated during the first hour (baseline). For the five treatment modalities, mean sputum dry and wet weights ranged between 122% and 185% of baseline. There was no statistically significant difference among the treatment modalities. As measured by sputum wet weight, all oscillatory devices tended to be less effective than CPT (p=0.15). As measured by dry weight, oral airway oscillation at 8 Hz with an I:E ratio of 9:1 and CPT tended to be more effective than the other treatment modalities (p=0.57). None of the treatment modalities had an effect on PFTs and oxygen saturation and all were well tolerated. Conclusion: In outpatients with stable CF, high-frequency oscillation applied via the airway opening or via the chest wall and CPT have comparable augmenting effects on expectorated sputum weight without changing PFYs or oxygen saturation. In contrast to CPT, high-frequency oral airway and chest wall oscillations are serf-administered, thereby containing health- care expenses.

Original languageEnglish
Pages (from-to)1019-1027
Number of pages9
JournalChest
Volume113
Issue number4
StatePublished - May 25 1998

Fingerprint

Chest Wall Oscillation
Cystic Fibrosis
Thorax
Sputum
Weights and Measures
Therapeutics
Oxygen
Outpatients
Respiratory Function Tests
Postural Drainage
Lung
Thoracic Wall

Keywords

  • Chest physical therapy
  • Cystic fibrosis
  • High-frequency oscillation
  • Mucus clearance

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine

Cite this

Effect of high-frequency oral airway and chest wall oscillation and conventional chest physical therapy on expectoration in patients with stable cystic fibrosis. / Scherer, Thomas A.; Barandun, Jürg; Martinez, Elena; Wanner, Adam; Rubin, Eben M.

In: Chest, Vol. 113, No. 4, 25.05.1998, p. 1019-1027.

Research output: Contribution to journalArticle

Scherer, Thomas A. ; Barandun, Jürg ; Martinez, Elena ; Wanner, Adam ; Rubin, Eben M. / Effect of high-frequency oral airway and chest wall oscillation and conventional chest physical therapy on expectoration in patients with stable cystic fibrosis. In: Chest. 1998 ; Vol. 113, No. 4. pp. 1019-1027.
@article{7942862542794675b031f1c1f9fa8c91,
title = "Effect of high-frequency oral airway and chest wall oscillation and conventional chest physical therapy on expectoration in patients with stable cystic fibrosis",
abstract = "Study objective: To compare the effect of high-frequency oral airway oscillation, high-frequency chest wall oscillation, and conventional chest physical therapy (CPT) on weight of expectorated sputum, pulmonary function, and oxygen saturation in outpatients with stable cystic fibrosis (CF). Design: Prospective randomized trial. Setting: Pediatric pulmonary division of a tertiary care center. Patients: Fourteen outpatients with stable CF recruited from the CF center. Interventions: Two modes of oral airway oscillation (1: frequency 8 Hz; inspiratory to expiratory [I:E] ratio 9:1; 2: frequency 14 Hz; I:E ratio 8:1), two modes of chest wall oscillation (1: frequency 3 Hz; I:E ratio 4:1; 2: frequency 16 Hz; I:E ratio 1:1, alternating with frequency 1.5 Hz, I:E ratio 6:1), and CPT (clapping, vibration, postural drainage, and encouraged coughing) were applied during the first 20 min of 4 consecutive hours. Measurements and results: Sputum was collected on an hourly basis for a total of 6 consecutive hours. During the first and the last hour, patients collected sputum without having any treatment and underwent pulmonary function tests (PFTs). Oxygen saturation was measured at 30-min intervals during hours 1 to 6. For the first 20 min of the second to the fifth hour, patients received one of the treatments. To assess the effect of the intervention, the weight of expectorated sputum during hours 2 to 6 was averaged and expressed as percentage of the weight expectorated during the first hour (baseline). For the five treatment modalities, mean sputum dry and wet weights ranged between 122{\%} and 185{\%} of baseline. There was no statistically significant difference among the treatment modalities. As measured by sputum wet weight, all oscillatory devices tended to be less effective than CPT (p=0.15). As measured by dry weight, oral airway oscillation at 8 Hz with an I:E ratio of 9:1 and CPT tended to be more effective than the other treatment modalities (p=0.57). None of the treatment modalities had an effect on PFTs and oxygen saturation and all were well tolerated. Conclusion: In outpatients with stable CF, high-frequency oscillation applied via the airway opening or via the chest wall and CPT have comparable augmenting effects on expectorated sputum weight without changing PFYs or oxygen saturation. In contrast to CPT, high-frequency oral airway and chest wall oscillations are serf-administered, thereby containing health- care expenses.",
keywords = "Chest physical therapy, Cystic fibrosis, High-frequency oscillation, Mucus clearance",
author = "Scherer, {Thomas A.} and J{\"u}rg Barandun and Elena Martinez and Adam Wanner and Rubin, {Eben M.}",
year = "1998",
month = "5",
day = "25",
language = "English",
volume = "113",
pages = "1019--1027",
journal = "Chest",
issn = "0012-3692",
publisher = "American College of Chest Physicians",
number = "4",

}

TY - JOUR

T1 - Effect of high-frequency oral airway and chest wall oscillation and conventional chest physical therapy on expectoration in patients with stable cystic fibrosis

AU - Scherer, Thomas A.

AU - Barandun, Jürg

AU - Martinez, Elena

AU - Wanner, Adam

AU - Rubin, Eben M.

PY - 1998/5/25

Y1 - 1998/5/25

N2 - Study objective: To compare the effect of high-frequency oral airway oscillation, high-frequency chest wall oscillation, and conventional chest physical therapy (CPT) on weight of expectorated sputum, pulmonary function, and oxygen saturation in outpatients with stable cystic fibrosis (CF). Design: Prospective randomized trial. Setting: Pediatric pulmonary division of a tertiary care center. Patients: Fourteen outpatients with stable CF recruited from the CF center. Interventions: Two modes of oral airway oscillation (1: frequency 8 Hz; inspiratory to expiratory [I:E] ratio 9:1; 2: frequency 14 Hz; I:E ratio 8:1), two modes of chest wall oscillation (1: frequency 3 Hz; I:E ratio 4:1; 2: frequency 16 Hz; I:E ratio 1:1, alternating with frequency 1.5 Hz, I:E ratio 6:1), and CPT (clapping, vibration, postural drainage, and encouraged coughing) were applied during the first 20 min of 4 consecutive hours. Measurements and results: Sputum was collected on an hourly basis for a total of 6 consecutive hours. During the first and the last hour, patients collected sputum without having any treatment and underwent pulmonary function tests (PFTs). Oxygen saturation was measured at 30-min intervals during hours 1 to 6. For the first 20 min of the second to the fifth hour, patients received one of the treatments. To assess the effect of the intervention, the weight of expectorated sputum during hours 2 to 6 was averaged and expressed as percentage of the weight expectorated during the first hour (baseline). For the five treatment modalities, mean sputum dry and wet weights ranged between 122% and 185% of baseline. There was no statistically significant difference among the treatment modalities. As measured by sputum wet weight, all oscillatory devices tended to be less effective than CPT (p=0.15). As measured by dry weight, oral airway oscillation at 8 Hz with an I:E ratio of 9:1 and CPT tended to be more effective than the other treatment modalities (p=0.57). None of the treatment modalities had an effect on PFTs and oxygen saturation and all were well tolerated. Conclusion: In outpatients with stable CF, high-frequency oscillation applied via the airway opening or via the chest wall and CPT have comparable augmenting effects on expectorated sputum weight without changing PFYs or oxygen saturation. In contrast to CPT, high-frequency oral airway and chest wall oscillations are serf-administered, thereby containing health- care expenses.

AB - Study objective: To compare the effect of high-frequency oral airway oscillation, high-frequency chest wall oscillation, and conventional chest physical therapy (CPT) on weight of expectorated sputum, pulmonary function, and oxygen saturation in outpatients with stable cystic fibrosis (CF). Design: Prospective randomized trial. Setting: Pediatric pulmonary division of a tertiary care center. Patients: Fourteen outpatients with stable CF recruited from the CF center. Interventions: Two modes of oral airway oscillation (1: frequency 8 Hz; inspiratory to expiratory [I:E] ratio 9:1; 2: frequency 14 Hz; I:E ratio 8:1), two modes of chest wall oscillation (1: frequency 3 Hz; I:E ratio 4:1; 2: frequency 16 Hz; I:E ratio 1:1, alternating with frequency 1.5 Hz, I:E ratio 6:1), and CPT (clapping, vibration, postural drainage, and encouraged coughing) were applied during the first 20 min of 4 consecutive hours. Measurements and results: Sputum was collected on an hourly basis for a total of 6 consecutive hours. During the first and the last hour, patients collected sputum without having any treatment and underwent pulmonary function tests (PFTs). Oxygen saturation was measured at 30-min intervals during hours 1 to 6. For the first 20 min of the second to the fifth hour, patients received one of the treatments. To assess the effect of the intervention, the weight of expectorated sputum during hours 2 to 6 was averaged and expressed as percentage of the weight expectorated during the first hour (baseline). For the five treatment modalities, mean sputum dry and wet weights ranged between 122% and 185% of baseline. There was no statistically significant difference among the treatment modalities. As measured by sputum wet weight, all oscillatory devices tended to be less effective than CPT (p=0.15). As measured by dry weight, oral airway oscillation at 8 Hz with an I:E ratio of 9:1 and CPT tended to be more effective than the other treatment modalities (p=0.57). None of the treatment modalities had an effect on PFTs and oxygen saturation and all were well tolerated. Conclusion: In outpatients with stable CF, high-frequency oscillation applied via the airway opening or via the chest wall and CPT have comparable augmenting effects on expectorated sputum weight without changing PFYs or oxygen saturation. In contrast to CPT, high-frequency oral airway and chest wall oscillations are serf-administered, thereby containing health- care expenses.

KW - Chest physical therapy

KW - Cystic fibrosis

KW - High-frequency oscillation

KW - Mucus clearance

UR - http://www.scopus.com/inward/record.url?scp=0031968050&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0031968050&partnerID=8YFLogxK

M3 - Article

C2 - 9554641

AN - SCOPUS:0031968050

VL - 113

SP - 1019

EP - 1027

JO - Chest

JF - Chest

SN - 0012-3692

IS - 4

ER -