High-frequency chest wall oscillation. Assistance to ventilation in spontaneously breathing subjects

In five supine normal subjects breathing spontaneously, we studied the effects of high-frequency chest wall oscillation (HFCWO), which was achieved by oscillating the pressure in an air-filled cuff wrapped around the lower thorax. Oscillations of 3.5 and 8 Hz (in randomized order) were applied for 15 minutes each at both maximal (mean of 90 to 102 cm H2O) and half-maximal peak tolerable cuff pressures. Fifteen minutes of control spontaneous ventilation preceded each HFCWO maneuver. The HFCWO resulted in a significant decrease in spontaneous minute ventilation (VES) at maximal and half-maximal pressures by 35 and 40 percent, respectively, at 3 Hz and by 26 and 35 percent, respectively, at 5 Hz, with little change in VES at 8 Hz. This occurred despite an unchanging arterial carbon dioxide tension at all frequencies. Arterial oxygen pressure increased at 3 Hz at maximal pressure but remained statistically unchanged at 3 Hz at half-maximal pressure and at 5 Hz and 8 Hz both at maximal and half-maximal pressures. We conclude that HFCWO may potentially assist ventilation in spontaneously breathing man without requiring an endotracheal tube.