Effect of chest wall oscillation on mucus clearance: comparison of two vibrators

This study was designed to investigate the effect of an experimental low-energy chest wall oscillator and of a commercial chest percussor on central airway mucociliary clearance. Five normal dogs were anesthetized, intubated, and placed supine in a trough to which the oscillator or percussor was mounted. Tracheal mucus velocity (TMV) was measured by radiopaque particle or charcoal spot movement. The commercial percussor (a fixed sinusoidal device) used at its minimum frequency of 40 Hz, produced a mean (+/- SE) maximum expiratory flow rate of 0.25 +/- 0.04 L/sec at the airway opening, and had no measurable effect on TMV. The experimental oscillator, when operated at a level sufficient to generate flows of 2-3 L/sec, and with an unbiased 13-Hz sine wave (estimated energy, 150 W), increased mean TMV to 204 +/- 13% of control (P less than 0.003); the percent increase was independent of baseline TMV. We conclude that moderate oscillatory power applied to the chest wall can enhance mucus clearance in central airways, but that currently available commercial percussors may not meet the mechanical requirements for this effect.