Purpose of Technology: High-frequency chest wall compression (HFCWC) is a mechanical, external thoracic oscillatory therapy for cystic fibrosis (CF) patients whose ability to clear pulmonary secretions is impaired. The purpose of HFCWC is to promote effective airway clearance and pulmonary function by altering airflow patterns and reducing sputum viscosity, thereby aiding mucociliary clearance.

Rationale: External chest compressions should force air into and out of the lungs, increasing the airflow-mucus interaction and reducing sputum viscosity. Loosened, mobilized sputum is more readily expectorated by patients with compromised mucociliary transport, thus reducing the risk of infection and impaired lung function.

Controversy: HFCWC may reduce the need for a respiratory therapist or trained caregiver who can deliver pulmonary care in patients with CF. However, the evidence is still unclear as to whether HFCWC is as effective as other forms of physiotherapy.

Relevant Questions:

  • Is HFCWC effective for increasing clearance of respiratory secretions and improving lung function:

    • Compared with other methods of mobilizing respiratory secretions?

    • Across variations in HFCWC pressures, frequencies, and waveforms?

  • Is HFCWC safe?

  • Have definitive patient selection criteria for the treatment of CF with HFCWC therapy been established?

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