Children with cerebral palsy (CP) have an increased risk of recurrent pneumonia from impaired airway clearance. Ineffective cough, poor oral secretion control, reduced mucociliary function from recurrent infections and chest wall abnormalities contribute to poor airway clearance. Improving airway clearance may reduce the number of pneumonias. There is very little information regarding the value of high frequency chest wall oscillation (HFCWO) in this population.
We performed a retrospective quality assurance review on 13 children with CP, follow0ed in our pediatric pulmonary clinic, who use HFCWO to enhance airway clearance.
Of the 13 children with CP, 5 are females, 8 males. Three children have tracheostomies, 7 have gastrostomy buttons. Hospital and clinic charts were reviewed to determine the number of emergency room (ER) visits and hospitalizations for respiratory problems including pneumonia and asthma. Calls were made to families to assess HFCWO usage and parental satisfaction. Parent recall and patient records documented 8 hospitalizations and 5 ER visits 1 year before HFCWO. Parents reported frequent illnesses requiring multiple antibiotics, 1 child missed 50 days of school, and another required increased oxygen use. After using HFCWO, 5 hospitalizations and 1 ER visit were documented. Parents reported less respiratory illnesses, less antibiotic use, and 1 child had a 58% reduction in missed school days. Six of the children have used HFCWO for more than 1 year; seven for at least 6 months. The average minutes of HFCWO use per day calculated from the hour meter was 41.3 minutes for 11 patients; information was not available on 2. Parental satisfaction with HFCWO was high with 9 parents expressing improvement in their child’s health and quality of life.
This retrospective analysis would suggest that there is benefit from HFCWO use in children with CP by declines in respiratory illnesses, antibiotic use, missed school days, hospitalizations and ER visits.
A controlled, prospectively designed study would be able to provide more scientific support for the use of the vest in this population.
Peggy Radford, None.