Patients suffering from neuromuscular disorders often struggle to clear sputum effectively, increasing their risk for pneumonia and respiratory failure. HFCWO therapy offers an airway clearance therapy solution that may reduce sputum production while simultaneously encouraging secretion mobilization.
HFCWO devices consist of an air generator and inflatable vest connected by large-bore tubing. The air generator sends bursts of air at various frequencies into the vest’s bladders, producing pressure pulses which stimulate chest walls.
How Does HFCWO Work?
HFCWO creates vibrations in the chest walls and helps loosen mucus from the lungs so it can be coughed or suctioned away more easily. A patient wears a vest connected to a small generator which sends air pulses through to create oscillatory chest wall oscillation (OCCO), or tighten and release like hugging, this action known as oscillatory chest wall oscillation (OCCO). These pulses jostle the lungs to loosen mucus out. HFCWO has proven effective in treating cystic Fibrosis, bronchiectasis primary Cilary Dykinesia and COPD symptoms more effectively.
Recent research examined the efficacy of HFCWO treatment on hospitalized COPD exacerbations patients. A total of 94 were randomly enrolled, randomly assigned either active HFCWO or sham HFCWO treatment and their outcomes showed significant improvements across all three measures used to measure dyspnea: BCSS, MMRC and CAT measurements; however those receiving active treatment experienced greater improvements overall than their counterparts who received only placebo treatment.
HFCWO was tested in hospitalized patients suffering from blunt chest wall trauma and was found to be safe and well tolerated by them, without any adverse events such as lines, drains, or catheters becoming dislodged during testing.
Retrospective claims-based analysis of 255 patients with bronchiectasis found a reduction in healthcare costs 12 months post HFCWO implementation, both all-cause and disease-specific costs were decreased significantly, including savings on hospital stays, antibiotic use, emergency room visits, physician office visit costs such as those for pulmonologists or primary care physicians visiting for analysis or bronchoscopies as well as hospital length of stay costs and savings in lengths of stay costs due to shorter length of stay periods or antibiotic use and hospital length of stays of stays vs length of stay costs as well.
AffloVest’s convenient design makes it a simple daily practice tool, while being covered by Medicare and most private health insurance plans under Healthcare Common Procedure Coding System (HCPCS) code E0483 for high frequency chest wall oscillation therapy.
Is HFCWO Effective?
Physiotherapy can be an invaluable source of relief for bronchiectasis patients, and there are various approaches available. Some methods are easier than others to carry out; all can prove beneficial to sufferers. One such therapy is High Frequency Chest Wall Oscillation therapy or HFCWO, in which wearers wear vests vibrating at a rapid rate to break up mucus build-up. Sessions of this therapy typically last 20-30 minutes two times daily for 20-30 minutes with five minute breaks in-between so patients can cough clear mucus out from their lungs and make sessions even more beneficial to these sufferers than ever.
Studies have demonstrated the efficacy and feasibility of HFCWO in improving both pulmonary function and quality of life for those requiring daily airway clearance1. HFCWO’s benefits are comparable to traditional physiotherapy techniques like oscillating positive expiratory pressure (OPEP), without its negative side effects or need for physical machinery; its simplicity makes it an attractive option for travelers or people unable to participate in conventional physiotherapy sessions.
There is evidence that HFCWO can reduce bronchiectasis flare-ups, an integral aspect of managing chronic bronchiectasis. More research needs to be conducted in order to ascertain which patient subgroups would most benefit from this approach.
HFCWO has proven itself an effective method for sputum expectoration; however, its benefits become even more prominent when combined with spirometry testing. Spirometry allows more information to be revealed about an individual’s lung health such as whether or not their lungs are oxygenated properly.
As the incidence of bronchiectasis continues to rise, it’s critical that individuals stay informed. Becoming informed on this condition and its management can give patients confidence when discussing it with healthcare providers and receiving appropriate treatment – this includes reviewing recent HFCWO resources and clinical trials related to it in order to feel ready to discuss them with healthcare providers – particularly since most cases of bronchiectasis occur during adulthood when effective treatments will likely be required.
Is HFCWO Safe?
Neuromuscular patients frequently struggle to clear pulmonary secretions, leading to pneumonia and respiratory failure. One treatment that may help clear secretions more efficiently is HFCWO; however, data regarding its efficacy compared with other therapies remains scarce. To gain more insight into HFCWO’s effectiveness on outcomes, researchers recently analyzed healthcare claims data in two large commercial insurance databases of patients prescribed HFCWO who also had an International Classification of Diseases Ninth Revision code for neuromuscular disorder.
Researchers conducted a comparison between HFCWO and intrapulmonary percussive ventilation (IPV), taking into account patient reported dyspnea, quality of life measures, health status assessments, bloodwork results and respiratory function tests. HFCWO resulted in significant improvements to quality of life scores as measured by mMRC Dyspnea Scale scores; Breathing Compliance with Daily Activities Score scores; COPD Assessment Test (CAT) scores; as well as slower rate of decline for FVC and DLCO values, indicative of reduced respiratory morbidity.
Though further research needs to be completed, these results indicate that HFCWO may be safe and effective in patients without cystic fibrosis bronchiectasis. Furthermore, research demonstrates how this therapy should be utilized alongside traditional approaches for managing the disease; HFCWO can improve quality of life through decreased symptoms, improved daily activities participation rates, lowering healthcare costs and overall cost reductions.
Studies have illustrated the benefits of HFCWO; however, not all doctors are familiar with bronchiectasis or how to utilize HFCWO for optimal results. Therefore, it’s vital that people living with bronchiectasis advocate for themselves by explaining to their physician why HFCWO should be part of their treatment plan and that HFCWO should be included as part of it. Doing this will ensure they’re receiving comprehensive care that includes effective therapies like HFCWO or IPV as part of bronchiectasis treatments; also, patients could ask their physicians whether HFCWO can replace IPV in terms of relieving symptoms while improving quality of life improvements for themselves or both treatments!
Is HFCWO a New Treatment?
HFCWO is a tried and tested treatment for cystic fibrosis; however, only recently has research explored its application in adults with non-cystic fibrosis bronchiectasis (NCFB). Studies have demonstrated its ability to improve lung function after just one instance of ACT delivered using a vibrating vest that oscillates chest wall oscillation to thin mucus from lung walls while stimulating cilia that help clear secretions away from cilia cells – usually lasting 20-30 minutes with five-minute breaks between sessions so patients can cough out loose secretions out.
The COAT trial, led by researchers at the University of Alberta, evaluated HFCWO-vest ACT against sham ACT in patients hospitalized for acute asthma or COPD exacerbations. Results demonstrated significant improvements to lung function with an average increase in forced expiratory volume per second (FEV1,pp) by 9.2% and decrease of 13.3% in vital capacity (FVC). Patients also reported decreased symptoms such as wheezing, coughing and shortness of breath as well as less need for bronchodilators use following HFCWO-vest ACT therapy.
This study was groundbreaking as it was the first to assess the efficacy of HFCWO in patients hospitalized for asthma or COPD exacerbations who also have both CF and NCFB, in combination with HFCWO-vest ACT therapy, to improve outcomes; assess whether combined therapies improve results; as well as determining long-term adherence rates to this therapy for improved patient outcomes.
As with any study, this one has some limitations to take into account. For instance, HFCWO-vest ACT length and frequency varied across studies which may have created heterogeneity among them – however subgroup analysis and random effects modeling were performed to mitigate any effects caused by such heterogeneity.
One limitation was the exclusion of many patients due to consent issues or refusal, limiting generalizability of results. Finally, as this phase II clinical trial focused primarily on measuring patient adherence and satisfaction during AECOPD use of HFCWO early use treatments during their early phase use, its sample size wasn’t sufficient for meaningful statistical analyses.
