The efficacy of high-frequency chest wall oscillation in children with community-acquired pneumonia

Abstract

Modern management of acute community-acquired pneumonia (CAP) should consider various components of pathogenesis, in particular the disturbance of the pulmonary function (PF) and changes of the mucociliary transport system (MCTS). The impairment of MCTS in CAP leads to disorder of the airway clearance, which causes changes of PF in the respiratory system. New opportunities for improving MCTS are related to the use of the modern, high-tech method of drainage of the bronchial tree - a high-frequency chest wall oscillation (HFCWO), which allows to restore the drainage function of the bronchi and improve PF. The objective of this study was to estimate the efficacy and safety of using HFCWO in the complex therapy (CT) of CAP in children. We enrolled and examined 56 children aged 6-16 with CAP confirmed by X-ray. The main group (MG) (n=36 children) received CT with the inclusion of HFCWO. The control group (CG) (n=20) was given only baseline therapy. Changes in respiratory clinical symptoms and indices of PF in children with CAP using HFCWO were studied. The improvement of the respiratory clinical symptoms was noted in children of MG manifested by reduction of dyspnea at rest in 91.7% of children and in physical activity in 86.1% of children, reducing the intensity of productive cough in 75.0% of children; the disappearance of moist râles in the lungs - in 77.8% of children. Changes of PF indices in children with CAP were accompanied by a significant improvement of VC, FVC, FEV1, MEF75, PEF. The data obtained give evidence of the favorable influence of HFCWO on the respiratory clinical symptoms and indices of PF in children with CAP. The advantages of this method are effectiveness, safety and combination with other methods of bronchial drainage.