Chest Wall Oscillation
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Chest Wall Oscillation
Chest wall oscillation is when devices are used in airway clearance therapy to clear excess mucus from lung airways (bronchi and bronchioles). It is principally used in the treatment of cystic fibrosis, but is gaining use in the treatment of other diseases, such as bronchiectasis, COPD, cerebral palsy and muscular dystrophy, in which excessive mucus can block airways due to excessive production or impaired clearance. This "passive system" is not dependent on the effort of the patient. It uses a compressor to inflate and deflate the vest rhythmically at timed intervals and thus imposes high frequency chest wall oscillations (HFCWO) that are transferred to the lungs. These oscillations thin thixotropic airway mucus, facilitating its removal by coughing. Delivery of air to the vest can be controlled manually. History The Vest system was developed by Warren Warwick, a pediatrician and cystic fibrosis expert, and Leland Hansen MPH, a senior scientist at the University of Minnesota, w ...
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Airway Clearance Therapy
Airway clearance therapy is treatment that uses a number of airway clearance techniques to clear the respiratory airways of mucus and other secretions. Several respiratory diseases cause the normal mucociliary clearance mechanism to become impaired resulting in a build-up of mucus which obstructs breathing, and also affects the cough reflex. Mucus build-up can also cause infection, and inflammation, and repeated infections can result in damage to the airways, and the lung tissue. All airway clearance therapy involves the techniques of coughing, or huffing that need to be used in conjunction with another airway clearance technique. Respiratory therapists make recommendations and give guidance for appropriate airway clearance therapies. They also give instruction in the use of various airway clearance techniques. Clearance techniques Airway clearance therapy uses different airway clearance techniques (ACTs) in a number of respiratory disorders including, cystic fibrosis, bronchiti ...
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Cough
A cough is a sudden expulsion of air through the large breathing passages that can help clear them of fluids, irritants, foreign particles and microbes. As a protective reflex, coughing can be repetitive with the cough reflex following three phases: an inhalation, a forced exhalation against a closed glottis, and a violent release of air from the lungs following opening of the glottis, usually accompanied by a distinctive sound. Frequent coughing usually indicates the presence of a disease. Many viruses and bacteria benefit, from an evolutionary perspective, by causing the host to cough, which helps to spread the disease to new hosts. Most of the time, irregular coughing is caused by a respiratory tract infection but can also be triggered by choking, smoking, air pollution, asthma, gastroesophageal reflux disease, post-nasal drip, chronic bronchitis, lung tumors, heart failure and medications such as angiotensin-converting-enzyme inhibitors (ACE inhibitors). Treatment should t ...
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United States Of America
The United States of America (U.S.A. or USA), commonly known as the United States (U.S. or US) or America, is a country primarily located in North America. It consists of 50 states, a federal district, five major unincorporated territories, nine Minor Outlying Islands, and 326 Indian reservations. The United States is also in free association with three Pacific Island sovereign states: the Federated States of Micronesia, the Marshall Islands, and the Republic of Palau. It is the world's third-largest country by both land and total area. It shares land borders with Canada to its north and with Mexico to its south and has maritime borders with the Bahamas, Cuba, Russia, and other nations. With a population of over 333 million, it is the most populous country in the Americas and the third most populous in the world. The national capital of the United States is Washington, D.C. and its most populous city and principal financial center is New York City. Paleo ...
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Minnesota
Minnesota () is a state in the upper midwestern region of the United States. It is the 12th largest U.S. state in area and the 22nd most populous, with over 5.75 million residents. Minnesota is home to western prairies, now given over to intensive agriculture; deciduous forests in the southeast, now partially cleared, farmed, and settled; and the less populated North Woods, used for mining, forestry, and recreation. Roughly a third of the state is covered in forests, and it is known as the "Land of 10,000 Lakes" for having over 14,000 bodies of fresh water of at least ten acres. More than 60% of Minnesotans live in the Minneapolis–Saint Paul metropolitan area, known as the "Twin Cities", the state's main political, economic, and cultural hub. With a population of about 3.7 million, the Twin Cities is the 16th largest metropolitan area in the U.S. Other minor metropolitan and micropolitan statistical areas in the state include Duluth, Mankato, Moorhead, Rochester, and ...
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Saint Paul, Minnesota
Saint Paul (abbreviated St. Paul) is the List of capitals in the United States, capital of the U.S. state of Minnesota and the county seat of Ramsey County, Minnesota, Ramsey County. Situated on high bluffs overlooking a bend in the Mississippi River, Saint Paul is a regional business hub and the center of Minnesota's government. The Minnesota State Capitol and the state government offices all sit on a hill close to the city's downtown district. One of the oldest cities in Minnesota, Saint Paul has several historic neighborhoods and landmarks, such as the Summit Avenue (St. Paul), Summit Avenue Neighborhood, the James J. Hill House, and the Cathedral of Saint Paul (Minnesota), Cathedral of Saint Paul. Like the adjacent and larger city of Minneapolis, Saint Paul is known for its cold, snowy winters and humid summers. As of the 2021 census estimates, the city's population was 307,193, making it the List of United States cities by population, 67th-largest city in the United State ...
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Pediatrician
Pediatrics ( also spelled ''paediatrics'' or ''pædiatrics'') is the branch of medicine that involves the medical care of infants, children, adolescents, and young adults. In the United Kingdom, paediatrics covers many of their youth until the age of 18. The American Academy of Pediatrics recommends people seek pediatric care through the age of 21, but some pediatric subspecialists continue to care for adults up to 25. Worldwide age limits of pediatrics have been trending upward year after year. A medical doctor who specializes in this area is known as a pediatrician, or paediatrician. The word ''pediatrics'' and its cognates mean "healer of children," derived from the two Greek words: (''pais'' "child") and (''iatros'' "doctor, healer"). Pediatricians work in clinics, research centers, universities, general hospitals and children's hospitals, including those who practice pediatric subspecialties (e.g. neonatology requires resources available in a NICU). History The earlie ...
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Warren Warwick
Warren J. Warwick was an American pediatrician, notable for co-inventing a chest wall oscillation device called the Vest Airway Clearance System, or "The Vest", a mechanical vest for clearing the lungs of children with cystic fibrosis. He was a professor of pediatric pulmonology at the University of Minnesota The University of Minnesota, formally the University of Minnesota, Twin Cities, (UMN Twin Cities, the U of M, or Minnesota) is a public university, public Land-grant university, land-grant research university in the Minneapolis–Saint Paul, Tw ..., where he was a faculty member for more than 50 years. He served as director of the Cystic Fibrosis Center at the University of Minnesota 1962 to 1999, recognized by peer institutions as among the best in the United States.PERSONAL HEALTH
By Jane E. Brody, Publis ...
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Vest Airway Clearance System
Warren J. Warwick was an American pediatrician, notable for co-inventing a chest wall oscillation device called the Vest Airway Clearance System, or "The Vest", a mechanical vest for clearing the lungs of children with cystic fibrosis. He was a professor of pediatric pulmonology at the University of Minnesota The University of Minnesota, formally the University of Minnesota, Twin Cities, (UMN Twin Cities, the U of M, or Minnesota) is a public university, public Land-grant university, land-grant research university in the Minneapolis–Saint Paul, Tw ..., where he was a faculty member for more than 50 years. He served as director of the Cystic Fibrosis Center at the University of Minnesota 1962 to 1999, recognized by peer institutions as among the best in the United States.PERSONAL HEALTH
By Jane E. Brody, Publis ...
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Mucus
Mucus ( ) is a slippery aqueous secretion produced by, and covering, mucous membranes. It is typically produced from cells found in mucous glands, although it may also originate from mixed glands, which contain both serous and mucous cells. It is a viscous colloid containing inorganic salts, antimicrobial enzymes (such as lysozymes), immunoglobulins (especially IgA), and glycoproteins such as lactoferrin and mucins, which are produced by goblet cells in the mucous membranes and submucosal glands. Mucus serves to protect epithelial cells in the linings of the respiratory, digestive, and urogenital systems, and structures in the visual and auditory systems from pathogenic fungi, bacteria and viruses. Most of the mucus in the body is produced in the gastrointestinal tract. Amphibians, fish, snails, slugs, and some other invertebrates also produce external mucus from their epidermis as protection against pathogens, and to help in movement and is also produced in fish to line the ...
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Bronchi
A bronchus is a passage or airway in the lower respiratory tract that conducts air into the lungs. The first or primary bronchi pronounced (BRAN-KAI) to branch from the trachea at the carina are the right main bronchus and the left main bronchus. These are the widest bronchi, and enter the right lung, and the left lung at each hilum. The main bronchi branch into narrower secondary bronchi or lobar bronchi, and these branch into narrower tertiary bronchi or segmental bronchi. Further divisions of the segmental bronchi are known as 4th order, 5th order, and 6th order segmental bronchi, or grouped together as subsegmental bronchi. The bronchi, when too narrow to be supported by cartilage, are known as bronchioles. No gas exchange takes place in the bronchi. Structure The trachea (windpipe) divides at the carina into two main or primary bronchi, the left bronchus and the right bronchus. The carina of the trachea is located at the level of the sternal angle and the fifth thoracic verte ...
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Thixotropy
Thixotropy is a time-dependent shear thinning property. Certain gels or fluids that are thick or viscous under static conditions will flow (become thinner, less viscous) over time when shaken, agitated, shear-stressed, or otherwise stressed ( time-dependent viscosity). They then take a fixed time to return to a more viscous state. Some non-Newtonian pseudoplastic fluids show a time-dependent change in viscosity; the longer the fluid undergoes shear stress, the lower its viscosity. A thixotropic fluid is a fluid which takes a finite time to attain equilibrium viscosity when introduced to a steep change in shear rate. Some thixotropic fluids return to a gel state almost instantly, such as ketchup, and are called pseudoplastic fluids. Others such as yogurt take much longer and can become nearly solid. Many gels and colloids are thixotropic materials, exhibiting a stable form at rest but becoming fluid when agitated. Thixotropy arises because particles or structured solutes re ...
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Muscular Dystrophy
Muscular dystrophies (MD) are a genetically and clinically heterogeneous group of rare neuromuscular diseases that cause progressive weakness and breakdown of skeletal muscles over time. The disorders differ as to which muscles are primarily affected, the degree of weakness, how fast they worsen, and when symptoms begin. Some types are also associated with problems in other organs. Over 30 different disorders are classified as muscular dystrophies. Of those, Duchenne muscular dystrophy (DMD) accounts for approximately 50% of cases and affects males beginning around the age of four. Other relatively common muscular dystrophies include Becker muscular dystrophy, facioscapulohumeral muscular dystrophy, and myotonic dystrophy, whereas limb–girdle muscular dystrophy and congenital muscular dystrophy are themselves groups of several – usually ultrarare – genetic disorders. Muscular dystrophies are caused by mutations in genes, usually those involved in making muscle proteins. ...
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