Increasing the quantity of lungs for transplantation using high-frequency chest wall oscillation: a proposal

The use of chest physiotherapy in donor patient management occupies an established place in most lung procurement protocols. Although its merits remain controversial and uncorroborated by direct data, some studies support the efficacy of chest physiotherapy in a variety of pulmonary patient populations. Comparative studies have shown that an airway clearance technology utilizing high-frequency chest wall oscillation clears pulmonary secretions as well as or better than chest physiotherapy, but has few of its contraindications and disadvantages. The implementation of high-frequency chest wall oscillation as part of the donor lung procurement protocol may increase rates of successful lung recovery by providing effective clearance of obstructing pulmonary secretions containing destructive by-products of inflammation and entrapped pathogens. High-frequency chest wall oscillation may also improve arterial blood gas values, a critical factor in increasing lung procurement rates. Although speculative, the benefits of high-frequency chest wall oscillation on donor lungs might improve perfusion and oxygenation of other organs for possible transplantation.