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Diagnosing Pulmonary EmbolismDiagnosing pulmonary embolism (PE) involves clinical assessment and advanced imaging tests. The preferred diagnostic tool is the spiral (helical) CT scan or CT angiography (CTA), which uses intravenous contrast media to visualize the pulmonary vasculature and identify emboli.A ventilation-perfusion (V/Q) scan is an alternative for patients unable to receive contrast media. This scan includes both perfusion and ventilation scanning. Perfusion scanning involves...
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Related Experiment Video

Updated: Mar 27, 2026

Conducting Respiratory Oscillometry in an Outpatient Setting
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High-Frequency Chest Wall Oscillation in Critical Care: A Systematic Review.

Simone Ielo1, Lorenzo Carriera2,3, Roberto Barone3

  • 1Pulmonology and Pulmonary Intensive Care Unit (PICU), San Donato Hospital, Arezzo, Italy, simone.ielo@uslsudest.toscana.it.

Respiration; International Review of Thoracic Diseases
|March 24, 2026
PubMed
Summary

High-frequency chest wall oscillation (HFCWO) is safe for ICU patients with airway secretions but lacks proven benefits for major clinical outcomes. More research is needed to determine its true impact and optimal use.

Keywords:
Airway clearance therapiesCritical careHigh-frequency chest wall oscillationMucus hypersecretion

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Area of Science:

  • Critical Care Medicine
  • Respiratory Therapy
  • Pulmonology

Background:

  • Airway secretion retention is a significant challenge in critically ill patients, leading to respiratory complications.
  • High-frequency chest wall oscillation (HFCWO) is a non-invasive technique, but its efficacy in the intensive care unit (ICU) is not well-established.
  • This review assesses the evidence for HFCWO in adult ICU patients.

Purpose of the Study:

  • To systematically review the efficacy and safety of HFCWO in adult ICU patients.
  • To evaluate the impact of HFCWO on mechanical ventilation duration, ICU stay, and mortality.
  • To assess HFCWO's effect on secretion clearance and patient tolerance.

Main Methods:

  • A systematic literature search was performed across major databases (PubMed/MEDLINE, Embase, Cochrane Library) up to December 2025.
  • Included studies evaluated HFCWO in adult ICU patients, including those on invasive or non-invasive respiratory support.
  • Primary outcomes were mechanical ventilation duration, ICU length of stay, and mortality; secondary outcomes included secretion clearance and safety.

Main Results:

  • Limited, heterogeneous studies (RCTs, observational) were included.
  • HFCWO showed variable and inconclusive effects on primary clinical outcomes like ventilation duration and mortality.
  • The technique was generally well-tolerated, appearing to aid secretion clearance with some modest improvements in oxygenation.

Conclusions:

  • HFCWO is a safe and feasible airway clearance option for selected ICU patients with secretion issues.
  • Current evidence does not support routine HFCWO use for improving major clinical outcomes.
  • High-quality randomized trials are necessary to establish optimal patient selection and clinical impact.