[A study of the value of high frequency chest wall oscillation in patients with acute exacerbation of chronic obstructive pulmonary disease]

Abstract

Objective: To explore the safety and efficacy of high-frequency chest wall oscillation (HFCWO) in invasive mechanical ventilation patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD).

Methods: A prospective, randomized, controlled trial was conducted. Thirty-five AECOPD patients with invasive mechanical ventilation were included in the intensive care unit of West China Hospital of Sichuan University from February 2012 to February 2013. The patients were randomly allocated into a HFCWO (H) group and a control group using SAS 9.1 software . The control group received routine therapy, while the H group received HFCWO, along with routine therapy. Invasive mechanical ventilation time, noninvasive ventilation time, total mechanical ventilation time, ICU stay time, hospital stay time and pH, oxygen index (OI) during the first 7 days were collected. At the same time, heart rate, blood pressure, respiratory rate, SpO2 and peak airway pressure before, during and after HFCWO and ventilation alarm of the H group were collected.

Results: The total mechanical ventilation time of patients in the H group was significantly shorter than that of the control group [(10 ± 6) d and (15 ± 8) d, P < 0.05]. But there were no significant differences between the 2 groups in invasive mechanical ventilation time, noninvasive ventilation time, ICU stay and hospital stay time (P > 0.05). There were no significant differences between the 2 groups in pH and oxygen index during the first 7 days (P > 0.05). There were no change in heart rate, blood pressure, respiratory rate, SpO2 and peak airway pressure before, during and after HFCWO in the H group (P > 0.05). Severe ventilator alarm(level 3) occurred in 3.67% patients, but there was no significant correlation between ventilation alarm and patient prognosis.

Conclusions: HFCWO is very safe and comfortable in ventilated patients with AECOPD. It reduces the total mechanical ventilation time, but cannot improve the prognosis.