High frequency chest wall oscillation use in non-cystic fibrosis bronchiectasis: a feasibility study

<b>Introduction or background:</b> Non-cystic fibrosis bronchiectasis (NCFB) is a chronic inflammatory disorder characterized by permanent dilation of the bronchi and mucus production. For these patients pulmonary rehabilitation and secretion clearance are the recommended treatment. High frequency chest wall oscillation (HFCWO) is a relatively new technique that may promote mucus expectoration and contribute to clinical stability as add-on therapy to usual airway clearance techniques (ACTs). <b>Aims and Objectives:</b> To evaluate the efficacy of HFCWO as add-on treatment to usual ACTs in patients with bronchiectasis and frequent exacerbations, in terms of pulmonary function and mucus expectoration. <b>Methods:</b> Four patients affected by NCFB with history of frequent exacerbations (BSI 11±4.4) and persistence of sputum production, dyspnea and cough despite ACTs, received ­­­­­­­six months of HFCWO home-based daily treatment. Pulmonary function test (FEV1), bronchiectasis severity index (BSI), arterial blood gas analysis, ease of expectoration Visual Analogue Scale (VAS) and sputum characteristic were collected before and after treatment. <b>Results:</b> HFCWO was effected in improving mucus expectoration (VAS from 6.5±1.3 to 3.7±0.9) as well lung function (FEV1% from 61±16.9 to 71±12.3, p&lt;0.05) and oxygen saturation (93.2±2.2 vs. 95.7±1.5, p&lt;0.05). <b>Conclusions:</b> HFCWO in addiction to ACTs may be a useful home-based treatment for patients with NCFB frequent exacerbation despite maximal medical and ACTs treatment.