Transcript Bronchial Hygiene: Why So Important?

Effect on Expiratory Flow
Normal
Flutter
Acapella
Aerobika
Fink et al. Resp Care 2002:47:7;797-807
High Frequency Assisted Airway
Techniques
High Frequency Chest Wall Oscillation
High Frequency Chest Wall Compression
Intrapulmonary Percussive Ventilation
High Frequency Chest Wall
Oscillation (HFCWO)
Achieved with rigid chest
cuirass delivering pos. &
neg. pressure breaths.
Hayek Oscillator System
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I:E=1:6 to 6:1 ratio
-70-+70cm H2O
Specialized “Secretion
Mode”
Flow, Airway Pressure, & Esophageal Pressure
Waveforms
HFCWO (Hayek Oscillator System)
Fink et al. Resp Care 2002:47:7;797-807
High Frequency Chest Wall
Compression (HFCWC)
Hil-Rom Vest
Uses inflatable Vest.
Actively compresses
chest wall (5-20 cm
H2O).
Generates short bursts
of expiratory flow
Deflation is passively
recoiled forcing
expiratory flow
inCourage
Smart Vest
Flow, Airway Pressure, & Esophageal
Pressure Waveforms
HFCWC- (Vest Therapies)
Fink et al. Resp Care 2002:47:7;797-807
Intrapulmonary Percussive Therapy
Intrapulmonay Percussive
Ventilation (IPV)
• 1985 Dr. Forest Bird
• 300-400 mini-bursts
MetaNeb (Hil-Rom)
• 3 in 1 system
• CPEP Therapy
• Aerosol Therapy
• High Frequency
Percussive Therapy.
Used in a variety of settings
Flow, Airway Pressure, & Esophageal
Pressure Waveforms
Intrapulmonary Percussion
Fink et al. Resp Care 2002:47:7;797-807
Mechanism of Action for High
Frequency Devices
OCI= Oscillatory Clearance Index
f= Oscillatory frequency (Hz)
TI=duration of outward
inspiratory airway wall
displacement
TE=duration of inward expiratiory
airway wall displacement
VE-max= Maximum exp. Flow
VI-max= Max insp. flow
A closer look at how mucus is
thought to be dislodged……..
1
Insp
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4
Exp