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Research ArticleConference Proceedings

High-Frequency Assisted Airway Clearance

Robert L Chatburn
Respiratory Care September 2007, 52 (9) 1224-1237;
Robert L Chatburn
Section of Respiratory Care, Cleveland Clinic, Cleveland, Ohio; Department of Medicine, Lerner College of Medicine, Case Western Reserve University, Cleveland, Ohio
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Abstract

High-frequency airway clearance assist devices generate either positive or negative transrespiratory pressure excursions to produce high-frequency, small-volume oscillations in the airways. Intrapulmonary percussive ventilation creates a positive transrespiratory pressure by injecting short, rapid inspiratory flow pulses into the airway opening and relies on chest wall elastic recoil for passive exhalation. High-frequency chest wall compression generates a negative transrespiratory pressure by compressing the chest externally to cause short, rapid expiratory flow pulses, and relies on chest wall elastic recoil to return the lungs to functional residual capacity. High-frequency chest wall oscillation uses a chest cuirass to generate biphasic changes in transrespiratory pressure. In any case (positive or negative pressure pulses or both), the general idea is get air behind secretions and move them toward the larger airways, where they can be coughed up and expectorated. These techniques have become ubiquitous enough to constitute a standard of care. Yet, despite over 20 years of research, clinical evidence of efficacy for them is still lacking. Indeed, there is insufficient evidence to support the use of any single airway clearance technique, let alone judge any one of them superior. Aside from patient preference and capability, cost-effectiveness studies based on existing clinical data are necessary to determine when a given technique is most practical.

  • high frequency
  • airway clearance
  • secretion removal
  • intrapulmonary percussive ventilation
  • high-frequency chest wall compression
  • high-frequency chest wall oscillation

Footnotes

  • Correspondence: Robert L Chatburn RRT-NPS FAARC, Respiratory Therapy, M-56, Cleveland Clinic, 9500 Euclid Avenue, Cleveland OH 44195. E-mail: chatbur{at}ccf.org.
  • Mr Chatburn presented a version of this paper at the 39th Respiratory Care Journal Conference, “Airway Clearance: Physiology, Pharmacology, Techniques, and Practice,” held April 21–23, 2007, in Cancún, Mexico.

  • The author reports no conflicts of interest related to the content of this paper.

  • Copyright © 2007 by Daedalus Enterprises Inc.
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Respiratory Care: 52 (9)
Respiratory Care
Vol. 52, Issue 9
1 Sep 2007
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High-Frequency Assisted Airway Clearance
Robert L Chatburn
Respiratory Care Sep 2007, 52 (9) 1224-1237;

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Robert L Chatburn
Respiratory Care Sep 2007, 52 (9) 1224-1237;
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Keywords

  • high frequency
  • airway clearance
  • secretion removal
  • intrapulmonary percussive ventilation
  • high-frequency chest wall compression
  • high-frequency chest wall oscillation

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