High frequency chest wall oscillation for asthma and chronic obstructive pulmonary disease exacerbations: a randomized sham-controlled clinical trialReport as inadecuate




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Respiratory Research

, 12:120

First Online: 01 December 2011Received: 12 June 2011Accepted: 10 September 2011

Abstract

BackgroundHigh frequency chest wall oscillation HFCWO is used for airway mucus clearance. The objective of this study was to evaluate the use of HFCWO early in the treatment of adults hospitalized for acute asthma or chronic obstructive pulmonary disease COPD.

MethodsRandomized, multi-center, double-masked phase II clinical trial of active or sham treatment initiated within 24 hours of hospital admission for acute asthma or COPD at four academic medical centers. Patients received active or sham treatment for 15 minutes three times a day for four treatments. Medical management was standardized across groups. The primary outcomes were patient adherence to therapy after four treatments minutes used-60 minutes prescribed and satisfaction. Secondary outcomes included change in Borg dyspnea score ≥ 1 unit indicates a clinically significant change, spontaneously expectorated sputum volume, and forced expired volume in 1 second.

ResultsFifty-two participants were randomized to active n = 25 or sham n = 27 treatment. Patient adherence was similarly high in both groups 91% vs. 93%; p = 0.70. Patient satisfaction was also similarly high in both groups. After four treatments, a higher proportion of patients in the active treatment group had a clinically significant improvement in dyspnea 70.8% vs. 42.3%, p = 0.04. There were no significant differences in other secondary outcomes.

ConclusionsHFCWO is well tolerated in adults hospitalized for acute asthma or COPD and significantly improves dyspnea. The high levels of patient satisfaction in both treatment groups justify the need for sham controls when evaluating the use of HFCWO on patient-reported outcomes. Additional studies are needed to more fully evaluate the role of HFCWO in improving in-hospital and post-discharge outcomes in this population.

Trial RegistrationClinicalTrials.gov: NCT00181285

Keywordsasthma chronic obstructive pulmonary disease high frequency chest wall oscillation airway mucus clearance List of abbreviationsBMIBody mass index

COAT TrialChest Wall Oscillation for Asthma and COPD ExacerbaTions Trial

COPDChronic obstructive pulmonary disease

EDEmergency department

FEV1Forced expired volume in 1 second

FVCForced vital capacity

HFCWOHigh frequency chest wall oscillation

Post-BDPost-bronchodilator.

Electronic supplementary materialThe online version of this article doi:10.1186-1465-9921-12-120 contains supplementary material, which is available to authorized users.

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Author: Amit K Mahajan - Gregory B Diette - Umur Hatipoğlu - Andrew Bilderback - Alana Ridge - Vanessa Walker Harris - Vijay Da

Source: https://link.springer.com/







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