None listed
Conditions
Brief summary
Patients with neuromuscular disease can have impaired airway clearance which may lead to respiratory deterioration and death. Physiotherapy is vital in assisting with airway clearance for this patient population. Recent studies have suggested the use of high-frequency chest wall oscillation (HFCWO), however, there is little physiological evidence to support its efficacy. This study will use electrical impedance tomography and lung ultrasound to assess pre and post-treatment lung volume changes for patients receiving standard chest physiotherapy and HFCWO.
Interventions
High frequency chest wall oscillation (HFCWO) is an airway clearance technique recommended for respiratory management of neuromuscular conditions. This technique applies oscillations to the chest via a vest or wrap using an air pulse generator at a frequency of up to 20 compressions per second. These oscillations are thought to generate shearing forces and bias expiratory flow in the airways, facilitating secretion clearance. Participants will receive HFCWO regardless of their involvement in thi
High frequency chest wall oscillation (HFCWO) is an airway clearance technique recommended for respiratory management of neuromuscular conditions. This technique applies oscillations to the chest via a vest or wrap using an air pulse generator at a frequency of up to 20 compressions per second. These oscillations are thought to generate shearing forces and bias expiratory flow in the airways, facilitating secretion clearance. Participants will receive HFCWO regardless of their involvement in this study. Observational measurements will be taken for the duration of each physiotherapy intervention and repeated daily until discharge from PICU.
Sponsors
Queensland Children's Hospital
Eligibility
Sex/Gender
All
Age
1 Months to 18 Years
Healthy volunteers
No
Inclusion criteria
Children aged up to 18 admitted to QCH PICU with the following: • Diagnosed neuromuscular disorder • Requiring chest physiotherapy for airway clearance • Using non-invasive ventilation, either for respiratory support, sleep, or with airway clearance and requiring an escalation of pressures during chest physiotherapy • In the acute phase of a respiratory exacerbation requiring intensive care admission • Parent or guardian able and willing to provide informed consent
Exclusion criteria
• Children with unclear or unconfirmed neuromuscular diagnosis • Children not requiring physiotherapy for airway clearance • Children contraindicated for non-invasive ventilation including significant and undrained pneumothorax, chest trauma, facial trauma or facial burns, severe cardiovascular compromise • Children contraindicated for treatment with HFCWO including open abdominal wounds, unstable spinal injuries, rib fractures, severe haemodynamic instability • Skin conditions which would preclude the use of electrodes as used in EIT or ECG monitoring, or application of gel for ultrasound imaging
Outcome results
None listed