Effect of Continuous High-Frequency Oscillation Therapy on Lung Aeration in Mechanically Ventilated Patients With Impaired Consciousness
Year: 2025
Type: article
Study designs: Randomized Controlled Trial, Clinical Trial
Abstract: BACKGROUND: Atelectasis frequently occurs in patients with impaired consciousness who are being treated with invasive mechanical ventilation. It is mainly caused by secretion accumulation, which can lead to longer durations of ventilation and ICU stay. RESEARCH QUESTION: Does continuous high-frequency oscillation (CHFO) therapy improve lung aeration and reduce atelectasis in adults with impaired consciousness who are mechanically ventilated? STUDY DESIGN AND METHODS: This multicenter, single-anonymized, randomized controlled trial was conducted across 11 hospitals in China. Adult patients with impaired consciousness (Glasgow Coma Scale score ≤ 8) who required invasive mechanical ventilation were randomly assigned in a 1:1 ratio to either the CHFO or usual care group. The CHFO group received 3 to 4 sessions daily. The primary outcome was the percent change in nonaerated lung tissue, measured by CT scan, from baseline to day 5, as analyzed in the intention-to-treat population. RESULTS: From June 19, 2023, to July 2, 2024, a total of 80 patients were included in the intention-to-treat analysis. Five patients from each group were excluded from the primary analysis due to incomplete CT scans. On day 5, the decrease in nonaerated lung tissue was greater in the CHFO group (-51.3%; 95% CI, -62.7 to -40.0) compared with the usual care group (-37.6%; 95% CI, -49.3 to -26.0), with a mean difference of -13.69% (95% CI, -24.86 to -2.52; P = .017). The CHFO group also had a higher number of ventilator-free days, a lower clinical pulmonary infection score, and a shorter ICU stay. No adverse events of interest were observed during the study. INTERPRETATION: In patients with impaired consciousness who are mechanically ventilated, 5 days of CHFO treatment was shown to significantly reduce nonaerated lung tissue. CLINICAL TRIAL REGISTRATION: Chinese Clinical Trial Registry; No.: ChiCTR2300070988; https://www.chictr.org.cn.
Source: CHEST Journal
Authors: Zhengyong Hu, Xuehua Pu, Rui Tang, Min Zhou, Weili Liu, Jiaqiong Li, Meifang Cui, Ying Zhu, Tao Yu, Jiangquan Yu, Xinhua Ma, Huiqing Ge, Qianghong Xu, Yuxuan Wang, Jinlei Ou, Zenggan Guan, Tao Chen, Xueyan Yuan, Mingjia Zheng, Hongxing Wang, Yi Yang, Haibo Qiu, Hui Chen, Ling Liu
Institutions: Zhongda Hospital Southeast University, Southeast University, The Affiliated Taizhou People's Hospital of Nanjing Medical University, Nanjing Medical University, University of Science and Technology of China, Northern Jiangsu People's Hospital, Yangzhou University, Xuzhou Central Hospital, Westlake University, Affiliated Hangzhou First People's Hospital, Westlake University, School of Medicine, Wannan Medical College, First Affiliated Hospital of Wannan Medical College, Central South University, Xiangya Hospital Central South University, Sir Run Run Shaw Hospital, Zhejiang University, Zhejiang Hospital, Shandong First Medical University, Liverpool School of Tropical Medicine, Xi'an Jiaotong University
Language: English
Subfield: Pulmonary and Respiratory Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
Estimated APC paid: $4,160
OpenAlex ID: W4414452855