Evaluation and selection of high-frequency chest wall oscillation modes in children with community-acquired pneumonia based on pulse oximetry
DOI:
https://doi.org/10.14739/2310-1210.2020.3.204946Keywords:
high-frequency chest wall oscillation, oximetry, pneumonia, childrenAbstract
The high-frequency chest wall oscillation (HFCWO) is a method of airway clearance therapy, which helps to restore the drainage function of the bronchial glands, improve the pulmonary function and pulmonary gas exchange in children with cystic fibrosis, atelectasis, and bronchiectasis.
Aim: to select effective modes of high-frequency chest wall oscillation for increase oxygen saturation in children with community-acquired pneumonia based on pulse oximetry data.
Materials and methods. The selection and evaluation of the HFCWO modes were performed in 261 children (girls – 47.1 % and boys – 52.9 %) aged 6–17 years with a moderate degree and acute course of community-acquired pneumonia (CAP) using eight oscillation modes of the Vest Airway Clearance System, Model 105. The effectiveness of the HFCWO modes was assessed on the 1st and 10th day of the disease by measuring the degree of arterial hemoglobin oxygen saturation (SpO2) using noninvasive transmission pulse oximetry with the use of a pulse oximeter, Series YX 300. The ROC analysis was performed, the area under the ROC curve (AUC) was presented with the associated 95 % confidence interval (CI).
Results. According to a comparison of the sensitivity and specificity of the ROC analysis method, the 1st mode of HFCWO is recommended to apply for preschool children of asthenic somatotype, which is confirmed by the highest AUC – 0.95 (95 % CI 0.86–1.00). The 2d mode of HFCWO should be included in the complex therapy for preschool children of normosthenic somatotype, which is confirmed by the highest AUC – 0.94 (95 % CI 0.88–1.00). For prepubertal children of asthenic somatotype the 3rd mode of HFCWO should be used based on the highest value of AUC – 0.93 (95 % CI 0.81–1.00). For prepubertal children of normosthenic somatotype, we recommend including the 4th mode of HFCWO with an AUC value of 0.94 (95 % CI 0.84–1.00) in the comprehensive treatment of CAP. Regarding the adolescents of asthenic somatotype, we recommend applying the 5th mode of HFCWO, the AUC of which is 0.97 (95 % CI 0.91–1.00). As for the adolescents of normosthenic somatotype, the 6th mode of HFCWO should be used based on the AUC– 0.98 (95 % CI 0.91–1.00).
Conclusions. To increase the effectiveness of community-acquired pneumonia treatment, it is necessary to include HFCWO in the daily therapy taking into account the optimal oscillation parameters. Modes 1-6 of HFCWO influence the level of oxygen saturation, improving it. It is recommended to use sparing oscillation modes (1, 3 and 5) for children with asthenic somatotype in complex therapy of pneumonia compared to children with normosthenic somatotype.
References
Bennett, N. J., Domachowske, J., & Steele, R. W. (2018, November 5). Pediatric Pneumonia. Medscape. https://emedicine.medscape.com/article/967822-overview
World Health Organization. (2019, August 2). Pneumonia. https://www.who.int/news-room/fact-sheets/detail/pneumonia/
Munkholm, M., & Mortensen, J. (2014). Mucociliary clearance: pathophysiological aspects. Clinical Physiology and Functional Imaging, 34(3), 171-177. https://doi.org/10.1111/cpf.12085
Morrow, B. M. (2019). Airway clearance therapy in acute paediatric respiratory illness: A state-of-the-art review. South African Journal of Physiotherapy, 75(1), Article 1295. https://doi.org/10.4102/sajp.v75i1.1295
Babakhanova, B. N., & Asherova, I. K. (2010). Metod vysokochastotnoi ostsillyatsii grudnoi kletki v lechenii detei s respiratornoi patologiei [Method of high-frequency oscillation of chest in treatment of children with respiratory pathology]. Voprosy sovremennoi pediatrii, 9(3), 117-120. [in Russian].
Nolan, P., Gourabathini, H., Tran, C., Paudel, S., & Romero, E. (2014). High Frequency Chest Wall Oscillation for Atelectasis in Infants and Toddlers: A Case Series Report. Chest, 146(4, Suppl. 2), 708A. https://doi.org/10.1378/chest.1992204
Ministry of Health of Ukraine. (2005, January 13). Pro zatverdzhennia Protokoliv nadannia medychnoi dopomohy ditiam za spetsialnistiu «dytiacha pulmonolohiia» [On the approval of Protocols for providing medical care to children on a specialty "pediatric pulmonology" (No. 18)]. https://zakon.rada.gov.ua/rada/show/v0018282-05 [in Ukrainian].
Floyd, J., Wu, L., Hay Burgess, D., Izadnegahdar, R., Mukanga, D., & Ghani, A. C. (2015). Evaluating the impact of pulse oximetry on childhood pneumonia mortality in resource-poor settings. Nature, 528(7580), S53-S59. https://doi.org/10.1038/nature16043
McCollum, E. D., King, C., Hollowell, R., Zhou, J., Colbourn, T., Nambiar, B., Mukanga, D., & Burgess, D. C. H. (2015). Predictors of treatment failure for non-severe childhood pneumonia in developing countries – systematic literature review and expert survey – the first step towards a community focused mHealth risk-assessment tool? BMC Pediatrics, 15, Article 74. https://doi.org/10.1186/s12887-015-0392-x
Downloads
How to Cite
Issue
Section
License
Authors who publish with this journal agree to the following terms:- Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
- Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
- Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access)
