Effect of high-frequency chest wall oscillation on pulmonary function after pulmonary lobectomy for non-small cell lung cancer

摘要

Objective: We examined the feasibility of high-frequency chest wall oscillationtherapy in immediate postoperative lung recruitment after pulmonary lobectomy for non-small cell lung cancer compared to conventional chest physiotherapy. Design: A prospective, single-blind, randomized trial was conducted at Samsung Medical Center between March 2010 and May 2010. Setting: Patients were randomized to either the high-frequency chest wall oscillation group or the conventional percussive physiotherapy (control) group. Patients: Briefly, the eligibility criteria included 1) participants between the ages of 35 and 70 yrs, 2) candidates of lobectomy for non-small cell lung cancer, and 3) the first elective surgery of the day. Sixty-six patients were enrolled in the study. Interventions: Patients in the control group had routine postoperative percussive chest physiotherapy four times a day. Participants in the high-frequency chest wall oscillation group received three sessions of high-frequency chest wall oscillation treatment every 8 hrs for 15mins starting 4 hrs after surgery. All the treatments and measurements were performed by randomly assigned nursing staff who had received standardized education for respiratory care and who were not aware of the details of the study. Measurements and Main Results: The primary outcome was postoperative change of forced expiratory volume for 1 sec, and secondary outcomes were changes in arterial oxygen partial pressure and saturation. Safety outcomes and pain scores were also investigated. Patients in the high-frequency chest wall oscillation group experienced significantly improved recovery of pulmonary function as assessed by forced expiratory volume for 1 sec on the third and fifth postoperative days (p = .03) and improved oxygenation on the first postoperative day (p < .01). There were no significant differences in pain score or analgesic requirements. There were no unexpected complications, such as hemodynamic deterioration, postoperative bleeding or chest tube, and wound problems associated with the high-frequency chest wall oscillation therapy. Conclusions: High-frequency chest wall oscillation therapy after pulmonary lobectomy resulted in significantly improved immediate postoperative pulmonary function recovery compared to conventional physiotherapy, without any significant adverse effects. These results suggest that high-frequency chest wall oscillation therapy may be a valuable tool in the postoperative care of non-small cell lung cancer patients with lobectomy.