Post-operative pneumonia continues to be a leading cause of mortality and morbidity in patients undergoing thoracic surgical procedures. High-frequency chest wall oscillation (HFCWO) is an established therapeutic adjunct to the management of patients affected by a variety of chronic disorders resulting in the impaired clearance of bronchopulmonary secretions. This study evaluates the utility of HFCWO in the post-operative management of thoracic surgical patients, who have a similar inability to clear bronchopulmonary secretions.
Twenty-five patients (ages 47–83) undergoing a wide variety of elective thoracic surgical procedures were randomly chosen to receive HFCWO as part of their routine post-operative care. HFCWO was applied by means of an air-pulse generator connected to a circumferential inflatable vest applied to the chest wall. The air-pulse generator was set to a frequency of 12Hz, and therapy was applied for 10 minutes. Routine hemodynamic and pulse oximetric data were collected before, during, and after treatment. Qualitative data regarding patient tolerance and preference (as compared to percussive chest physiotherapy) were also collected.
No major adverse events were encountered during or subsequent to HFCWO. Hemodynamic and pulse oximetric data also remained stable throughout the treatment period. Eighty-four percent of patients reported little or no discomfort during therapy, and HFCWO was preferred to conventional chest physiotherapy by a 2:1 margin.CONCLUSIONS: HFCWO is a safe, well-tolerated adjunct to the routine post-operative treatment of elective thoracic surgical patients. The observation of hemodynamic stability is especially significant considering that the patients were studied in the early post-operative period, with active epidural pain management.
These data demonstrate that HFCWO can be used safely with a high degree of patient acceptance in an acute surgical population. Moreover, HFCWO was observed to provide each patient with chest physiotherapy that was consistent in quality, with the prospect of significant cost-savings.
J.S. Allan, Advanced Respiratory, Inc., grant monies.