High frequency chest wall oscillations may help reduce exacerbation in COPD patients

A new study published in International Journal of Chronic Obstructive Pulmonary Disease shows that the administration of high-frequency chest wall oscillation (HFCWO) may benefit acute exacerbation of chronic obstructive pulmonary disease (AECOPD) patients by improving the efficiency of sputum clearance and reducing the length of hospital stays.

Patients with chronic obstructive pulmonary disease (COPD) frequently have excessive sputum blockage of the airway. A higher bacterial load, a faster deterioration in lung function, exacerbations, and a higher likelihood of COPD hospitalization are all linked to mucus hypersecretion. HFCWO is currently used to treat a number of respiratory, neurological, and neuromuscular conditions, despite the fact that it was first recommended to people with cystic fibrosis. In order to determine the effectiveness of HFCWO for sputum expectoration and hospital length of stay in patients with acute exacerbations of COPD, Huang HP and colleagues conducted this study. Investigations were also conducted on the improvements in oxygenation and pulmonary function.

The Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) standards were followed in this systematic review and meta-analysis. From the earliest records through March 31, 2022, automated literature database searches were done. Using the Cochrane Risk of Bias tool (RoB 2.0) and RevMan 5.4 meta-analysis software, the methodological quality of the included studies was evaluated.

The key findings of this review were:

1. 13 papers (with 756 patients) were selected for this meta-analysis from the 5439 publications that were found.

2. HFCWO substantially raised expectorated sputum volume by 6.18 mL and decreased hospital stay by 4.37 days as compared to other airway clearing procedures.

3. FEV1 (%), PaO2, and PaCO2 did not significantly improve.

In conclusion, the HFCWO intervention components, session lengths, and oscillation frequency variations seen in this meta-analysis may have contributed to study heterogeneity. In order to decrease the influence of heterogeneity, this carried out a subgroup analysis and used a random effects model to the analysis. Our study also covers Chinese and English literature, but part of the latter is obscure outside of China, which may restrict the study's applicability to other cultures.

Reference:

Huang, H.-P., Chen, K.-H., Tsai, C.-L., Chang, W.-P., Chiu, S. Y.-H., Lin, S.-R., & Lin, Y.-H. (2022). Effects of High-Frequency Chest Wall Oscillation on Acute Exacerbation of Chronic Obstructive Pulmonary Disease: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. In International Journal of Chronic Obstructive Pulmonary Disease: Volume 17. Informa UK Limited. https://doi.org/10.2147/copd.s378642