Physiologic evidence for high-frequency chest wall oscillation and positive expiratory pressure breathing in hospitalized subjects with cystic fibrosis.
Study design (if review, criteria of inclusion for studies)
RCT
Participants
Participants were admitted to hospital for acute exacerbation. All participants performed HFCWO 1 - 3 times daily as outpatients before admission, but none had performed PEP. 15 participants, 8 males, 7 females. Aged at least 7 years, mean (SD) age 17.5 (4.2) years.
Interventions
Treatment lasted 30 minutes. PEP versus HFCWO. Both treatments were alternated within 48 hours of hospital admission and then reversed prior to discharge.
Outcome measures
RFTs and SaO2 measured before and after every intervention. Each intervention was only done twice i.e. day 1 or 2 following admission then day -1 or -2 prior to discharge.
Main results
At admission and discharge, PEP breathing increased SpO2 during treatment, whereas HFCWO decreased SpO2 during treatment. Ventilation distribution, gas mixing, and lung function improved after HFCWO or PEP breathing.
Authors' conclusions
High-frequency chest wall oscillation and PEP breathing are similarly efficacious in improving ventilation distribution, gas mixing, and pulmonary function in hospitalized people with CF. Because SpO2 decreases during HFCWO, people who have moderate to severe CF and who use HFCWO should have SpO2 monitored during an acute exacerbation.