Effect on Expiratory Flow Normal Flutter Acapella Aerobika
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 • • • I: E=1: 6 to 6: 1 ratio -70 -+70 cm H 2 O 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 H 2 O). Generates short bursts of expiratory flow Deflation is passively recoiled forcing expiratory flow in. Courage 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 Meta. Neb (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 2 3 4 Exp
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