Abstract:
BACKGROUND:High 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). METHODS:Randomized, 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. RESULTS:Fifty-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. CONCLUSIONS:HFCWO 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 REGISTRATION:ClinicalTrials.gov: NCT00181285.
journal_name
Respir Resjournal_title
Respiratory researchauthors
Mahajan AK,Diette GB,Hatipoğlu U,Bilderback A,Ridge A,Harris VW,Dalapathi V,Badlani S,Lewis S,Charbeneau JT,Naureckas ET,Krishnan JAdoi
10.1186/1465-9921-12-120subject
Has Abstractpub_date
2011-09-10 00:00:00pages
120eissn
1465-9921issn
1465-993Xpii
1465-9921-12-120journal_volume
12pub_type
杂志文章,多中心研究,随机对照试验abstract::The role of autoimmunity targeting epithelial antigens in asthma has been suggested, in particular in non-atopic and severe asthma. Periplakin, a desmosomal component, is involved in epithelial cohesion and intracellular signaling. We detected anti-periplakin IgG antibodies in 47/260 (18 %) patients with asthma, with ...
journal_title:Respiratory research
pub_type: 信件
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pub_type: 杂志文章,评审
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pub_type: 临床试验,杂志文章
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pub_type: 杂志文章
doi:10.1186/1465-9921-8-23
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pub_type: 信件,评审
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pub_type: 杂志文章,随机对照试验
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pub_type: 杂志文章,多中心研究,随机对照试验
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pub_type: 杂志文章
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更新日期:2011-11-09 00:00:00
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pub_type: 杂志文章
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更新日期:2005-12-19 00:00:00
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pub_type: 杂志文章
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