High-Frequency Chest Wall Oscillation in Patients with COVID-19: A Pilot Feasibility Study

Mine Çelik, Ahmet Murat Yayık, Buğra Kerget, Ferhan Kerget, Ömer Doymuş, Alperen Aksakal, Sevilay Özmen, Mehtap Hülya Aslan, Yakup Uzun, Mine Çelik, Ahmet Murat Yayık, Buğra Kerget, Ferhan Kerget, Ömer Doymuş, Alperen Aksakal, Sevilay Özmen, Mehtap Hülya Aslan, Yakup Uzun

Abstract

Objective: Coronavirus 2019 disease presents in a spectrum that can range from mild viral infection to pneu- monia. Common symptoms of coronavirus disease 2019 pneumonia include cough, sputum, and shortness of breath. High-frequency chest wall oscillation is a pulmonary rehabilitation method used for the recovery of pulmonary functions and removal of secretions in the lungs. The aim of the study was to evaluate the efficacy of high-frequency chest wall oscillation on patients with coronavirus disease 2019 pneumonia.

Materials and methods: In this study, 100 patients, between 18 and 70 years old, with a positive polymerase chain reaction result for coronavirus disease 2019, were included. Standard medical treatment was applied to all patients. In group rehabilitation, high-frequency chest wall oscillation treatment was applied twice a day for 20 minutes for 5 days. No additional intervention was made to the control group. Pulmonary function tests and oxygenation were evaluated on the first and fifth days. Patients' high-flow oxygen, non-invasive mechani- cal ventilation, and invasive mechanical ventilation needs were evaluated and recorded.

Results: Compared with the control group, the forced expiratory volume in 1 second, forced vital capacity, and peak expiratory flow rates were statistically higher in the rehabilitation group on the fifth day (P < .05). On evaluating the oxygenation of patients, the fifth day to first-day oxygen saturation difference was signifi- cantly higher in rehabilitation group than in control group (P < .05). Furthermore, the number of patients who needed non-invasive mechanical ventilation was lower in the rehabilitation group (P < .05).

Conclusion: This study demonstrated that pulmonary rehabilitation applied with the high-frequency chest wall oscillation device in patients with coronavirus disease 2019 in the early period contributed to the improvement of oxygenation by providing significant improvement as observed in the pulmonary function tests of the patients.

Figures

Figure 1.
Figure 1.
Application of high-frequency chest wall oscillation.
Figure 2.
Figure 2.
Consolidated standards of reporting trials.
Figure 3. a-d.
Figure 3. a-d.
Histopathological examination of sputum samples (hematoxylin and eosin ×20), (a and b) Sputum sample with sufficient criteria, black arrow: alveolar histiocyte, blue arrow: bronchial epithelial cell. (c and d) Insufficient cytological material, oropharyngeal content, yellow arrow: candida hyphae and spores of oral flora, green and red arrow: squamous epithelial cells of the oral mucosa.

References

    1. Cates J, Lucero-Obusan C, Dahl al. Risk for in-hospital complications associated with COVID-19 and Influenza - Veterans Health Administration, United States, October 1, 2018-May 31, 2020. MMWR Morb Mortal Wkly Rep. 2020;69(42):1528 1534. 10.15585/mmwr.mm6942e3)
    1. World Health O. Clinical Management of Severe Acute Respiratory Infection (SARI) When COVID-19 Disease Is Suspected: Interim Guidance. Geneva: World Health Organization; 2020:2020.
    1. Kerget B, Akgun M, Dogan N. Atypical presentation of COVID-19: acute renal failure. Eurasian J Med. 2020;52(2):224 226. 10.5152/eurasianjmed.2020.20134)
    1. Yuksel A, Karadogan D, Gurkan al. Unclear issues Regarding COVID-19. Eurasian J Med. 2020;52(2):191 196. 10.5152/eurasianjmed.2020.20092)
    1. Warwick WJ, Hansen LG. The long-term effect of high-frequency chest compression therapy on pulmonary complications of cystic fibrosis. Pediatr Pulmonol. 1991;11(3):265 271. 10.1002/ppul.1950110314)
    1. Kluft J, Beker L, Castagnino M, Gaiser J, Chaney H, Fink RJ. A comparison of bronchial drainage treatments in cystic fibrosis. Pediatr Pulmonol. 1996;22(4):271 274. 10.1002/(SICI)1099-0496(199610)22:4<271::AID-PPUL7>;2-P)
    1. Hansen LG, Warwick WJ. High-frequency chest compression system to aid in clearance of mucus from the lung. Biomed Instrum Technol. 1990;24(4):289 294.
    1. King M, Phillips DM, Gross D, Vartian V, Chang HK, Zidulka A. Enhanced tracheal mucus clearance with high frequency chest wall compression. Am Rev Respir Dis. 1983;128(3):511 515. 10.1164/arrd.1983.128.3.511)
    1. Barto TL, Maselli DJ, Daignault al. Real-life experience with high-frequency chest wall oscillation vest therapy in adults with non-cystic fibrosis bronchiectasis. Ther Adv Respir Dis. 2020;14:1753466620932508. 10.1177/1753466620932508)
    1. Fitzgerald K, Dugre J, Pagala S, Homel P, Marcus M, Kazachkov M. High-frequency chest wall compression therapy in neurologically impaired children. Respir Care. 2014;59(1):107 112. 10.4187/respcare.02446)
    1. Nicolini A, Cardini F, Landucci N, Lanata S, Ferrari-Bravo M, Barlascini C. Effectiveness of treatment with high-frequency chest wall oscillation in patients with bronchiectasis. BMC Pulm Med. 2013;13:21. 10.1186/1471-2466-13-21)
    1. Page RoTMC-I. COVID 19 treatment Guide for adult Patients 2020. Available at:
    1. Aytür YK, Köseoğlu BF, Taşkiran al. SARS-CoV-2 (COVID-19) Sonrası Pulmoner Rehabilitasyon Prensipleri: Akut ve Subakut Sürecin Yönetimi İçin Rehber Pulmonary Rehabilitation Principles after SARS-CoV-2 (COVID-19): A Guideline for the Management of Acute and Subacute Course.
    1. Thomas P, Baldwin C, Bissett al. Physiotherapy management for COVID-19 in the acute hospital setting: clinical practice recommendations. J Physiother. 2020;66(2):73 82. 10.1016/j.jphys.2020.03.011)
    1. Lim PA, Ng YS, Tay BK. Impact of a viral respiratory epidemic on the practice of medicine and rehabilitation: severe acute respiratory syndrome. Arch Phys Med Rehabil. 2004;85(8):1365 1370. 10.1016/j.apmr.2004.01.022)
    1. Guo YR, Cao QD, Hong al. The origin, transmission and clinical therapies on coronavirus disease 2019 (COVID-19) outbreak - an update on the status. Mil Med Res. 2020;7(1):11. 10.1186/s40779-020-00240-0)
    1. Piquet J, Brochard L, Isabey al. High frequency chest wall oscillation in patients with chronic air-flow obstruction. Am Rev Respir Dis. 1987;136(6):1355 1359. 10.1164/ajrccm/136.6.1355)
    1. Perry RJ, Man GC, Jones RL. Effects of positive end-expiratory pressure on oscillated flow rate during high-frequency chest compression. Chest. 1998;113(4):1028 1033. 10.1378/chest.113.4.1028)
    1. Arens R, Gozal D, Omlin al. Comparison of high frequency chest compression and conventional chest physiotherapy in hospitalized patients with cystic fibrosis. Am J Respir Crit Care Med. 1994;150(4):1154 1157. 10.1164/ajrccm.150.4.7921452)
    1. Oermann CM, Sockrider MM, Giles D, Sontag MK, Accurso FJ, Castile RG. Comparison of high-frequency chest wall oscillation and oscillating positive expiratory pressure in the home management of cystic fibrosis: a pilot study. Pediatr Pulmonol. 2001;32(5):372 377. 10.1002/ppul.1146)
    1. Thoren L. Post-operative pulmonary complications: observations on their prevention by means of physiotherapy. Acta Chir Scand. 1954;107(2-3):193 205.
    1. Fagevik Olsén M, Hahn I, Nordgren S, Lönroth H, Lundholm K. Randomized controlled trial of prophylactic chest physiotherapy in major abdominal surgery. Br J Surg. 1997;84(11):1535 1538. 10.1111/j.1365-2168.1997.02828.x)
    1. Stiller KR, Munday RM. Chest physiotherapy for the surgical patient. Br J Surg. 1992;79(8):745 749. 10.1002/bjs.1800790807)
    1. Warwick WJ, Wielinski CL, Hansen LG. Comparison of expectorated sputum after manual chest physical therapy and high-frequency chest compression. Biomed Instrum Technol. 2004;38(6):470 475.
    1. Nicolini A, Grecchi B, Ferrari-Bravo M, Barlascini C. Safety and effectiveness of the high-frequency chest wall oscillation vs intrapulmonary percussive ventilation in patients with severe COPD. Int J Chron Obstruct Pulmon Dis. 2018;13:617 625. 10.2147/COPD.S145440)
    1. Braveman J, Nozzarella M. High-frequency chest compression advanced therapy for obstructive lung disease. Resp Ther. 2007;2:48 51.
    1. Liu K, Zhang W, Yang Y, Zhang J, Li Y, Chen Y. Respiratory rehabilitation in elderly patients with COVID-19: a randomized controlled study. Complement Ther Clin Pract. 2020;39:101166.
    1. Huang WC, Wu PC, Chen al. High-frequency chest wall oscillation in prolonged mechanical ventilation patients: a randomized controlled trial. Clin Respir J. 2016;10(3):272 281. 10.1111/crj.12212)

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