High Frequency Chest Wall Oscillation (HFCWO) | How Does It Work? | Airway Clearance

“We love the portability of it, how easy it is to use, and how easy it is to clean the SmartVest®”
— Mother of a CF patient

HFCWO creates a gentle and rapid SQUEEZE and RELEASE action around the chest from 5 to 20 times per second.


The "mini-coughs" produced with SmartVest® HFCWO treatments
	Shear mucus away from the walls of the airways
	Reduce the viscosity of secretions
	Propel mucus towards the larger airways where it can be expectorated or suctioned more easily

How Does HFCWO Work?

mEchanism of action

High Frequency Chest Wall Oscillation (HFCWO, also known as High Frequency Chest Compression (HFCC), has been an effective form of airway clearance therapy for over 20 years. HFCWO, administered by the patented SmartVest®, creates a revolutionary SQUEEZE and RELEASE action around the chest and torso from 5-20 times per second, delivering an effective and comfortable treatment. The SmartVest® inflates and delivers vigorous, yet comfortable, air pulses to the body through a single-hose powered by a programmable air pulse generator. The rapid squeeze and release action simulates repetitive “mini-coughs,” which have been reported in the medical literature to effectively

	Shear mucus away from the walls of a lung’s airways (1)
	Reduce the viscosity of the secretions (2)
	Propel the mucus toward the larger airways where it can be expectorated or suctioned more easily (1,2)

Efficacy of HFCWO

HFCWO has been studied extensively and often compared to hospital quality Chest Physiotherapy (CPT), a level of treatment that can rarely be maintained in the home. In contrast to CPT, the quality of HFCWO treatment does not change in home settings. CPT requires a caregiver to clap and vibrate the chest wall to loosen the secretions. This is combined with placing the patient in head-down positions so gravity may assist in draining secretions from the airway. Unlike CPT, HFCWO is technique-independent, eliminating inconsistencies in clapping or cupping by the caregiver. Also, because HFCWO employs a mechanism different than that of CPT, it has advantages that make it a superior choice for airway clearance therapy in the home.

Advantages of HFCWO

	Greater independence and adherence to prescribed treatment - Most patients can self-administer the treatment, eliminating dependence on a caregiver’s ability and availability, thus preventing missed treatments due to lack of access to treatment. The *SmartVest® Airway Clearance System* is designed for travel and portability, increasing independence.
	Position-independent - The *SmartVest® Airway Clearance System* eliminates concerns associated with manual Chest Physiotherapy (CPT) regarding patient positioning in the Trendelenburg position and individual technique variance.
	Greater comfort and privacy - By eliminating the need for head-down positioning, patients who cannot tolerate positioning still have access to highly effective HFCWO treatment. The compressions of the SmartVest® are gentler than the clapping of CPT, and the *SmartVest*® material is soft and breathable against the skin. The air pulse generator is designed to avoid the appearance of medical equipment, providing a higher level of privacy to the patient.
	Time saving - All areas of the lung are treated simultaneously, and nebulized therapies can often be incorporated into the treatment session, allowing the patient to complete multiple therapies at the same time. A typical treatment is administered twice a day and can take from 15 to 30 minutes depending on physician order.

Electromed, Inc.’s SmartVest® Airway Clearance System is designed to deliver High Frequency Chest Wall Oscillation to promote airway clearance and improve bronchial drainage. It is available only by prescription.

For references, contact Electromed, Inc. at 800-462-1045.

1- Chang HK, Weber ME, King M. Mucus transport by high-frequency nonsymmetrical oscillatory airflow. J Appl Physiol 1988; 65(3): 1203-1209.
2- Majaesic C, Montgomery M, Jones R, King M. Reduction in sputum viscosity using high frequency chest compressions compared to conventional chest physiotherapy. Pediatr Pulmonol 1996; Suppl 13: A358.