Open AccessHigh‐frequency chest wall oscillation in prolonged mechanical ventilation patients: a randomized controlled trial
Author(s) -
Huang WeiChang,
Wu PiChu,
Chen ChaoJung,
Cheng YaHua,
Shih SouJen,
Chen HuiChen,
Wu ChiehLiang
Publication year - 2016
Publication title -
the clinical respiratory journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.789
H-Index - 33
eISSN - 1752-699X
pISSN - 1752-6981
DOI - 10.1111/crj.12212
Subject(s) - medicine , mechanical ventilation , sputum , anesthesia , randomized controlled trial , surgery , tuberculosis , pathology
Background and Aims Patients with prolonged mechanical ventilation ( PMV ) often retain airway secretions, which may be cleared with the assistance of high‐frequency chest wall oscillation ( HFCWO ). This study aimed to determine the effectiveness, safety and tolerance/comfort of HFCWO after extubation in PMV patients. Methods This parallel‐designed, randomized controlled trial enrolled subjects with both intra‐tracheal intubation and mechanical ventilator support continuously for at least 21 days between J anuary 2011 and D ecember 2012. Upon extubation, the participants were randomly assigned to either receive HFCWO for 5 days or not. The effectiveness [based on weaning success rates, daily clearance volume of sputum, serial changes in sputum coloration and chest X ‐ray ( CXR ) improvement rates], safety (by physiologic parameters) and tolerance/comfort [using the M odified B org S cale ( MBS ) and H amilton A nxiety S cale ( HAS )] of HFCWO were investigated. Results There were 43 PMV subjects, including 23 in the HFCWO group and 20 in the non‐ HFCWO group. The weaning success rates were 82.6% (19/23) and 85% (17/20) in the HFCWO and non‐ HFCWO groups, respectively ( P = 1.000). The HFCWO group had persistently greater numbers of daily sputum suctions and higher CXR improvement rates compared with the non‐ HFCWO group. There was significant sputum coloration lightening in the HFCWO group only. There was no significant difference in the MBS and HAS between the two groups and between pre‐ and post‐ HFCWO physiologic parameters. Conclusion In PMV patients, HFCWO was safe, comfortable and effective in facilitating airway hygiene after removal of endotracheal tubes, but had no positive impact on weaning success.