Name of the Procedure:

Mechanical Chest Wall Oscillation (MCWO)
Common name(s): High-Frequency Chest Wall Oscillation (HFCWO), The Vest Therapy

Summary

Mechanical Chest Wall Oscillation is a non-invasive therapy used to help individuals clear mucus from their lungs. The procedure involves wearing an inflatable vest that vibrates at high frequencies, loosening mucus so it can be more easily coughed up.

Purpose

This procedure is designed to assist people with lung conditions that cause mucus buildup, such as cystic fibrosis, chronic obstructive pulmonary disease (COPD), or bronchiectasis. The goal is to improve breathing function and decrease the risk of lung infections.

Indications

Mechanical Chest Wall Oscillation is indicated for patients who have difficulty clearing mucus from their lungs. Specific conditions include cystic fibrosis, COPD, bronchiectasis, and other chronic respiratory disorders. It is suitable for both adults and children as prescribed by a healthcare provider.

Preparation

There are generally no special preparations required before undergoing MCWO. Patients may be instructed to take prescribed medications as usual. It's advisable to wear comfortable clothing.

Procedure Description

1. The patient wears an inflatable vest connected to an air-pulse generator.
2. The generator delivers rapid bursts of air to the vest, causing it to inflate and deflate.
3. This action creates oscillations that vibrate the chest wall, loosening mucus in the lungs.
4. The patient may be encouraged to perform breathing exercises or cough to help expel mucus.
5. The procedure is painless and does not require anesthesia.

Duration

Each MCWO session typically lasts about 20 to 30 minutes.

Setting

The procedure can be performed in various settings, including hospitals, outpatient clinics, or even at home with a portable device.

Personnel

Usually managed by respiratory therapists or trained healthcare professionals. Patients can also be trained to perform the procedure themselves at home.

Risks and Complications

MCWO is generally safe, but possible risks include:

• Skin irritation or bruising from the vest
• Discomfort or increased coughing
• Rarely, shortness of breath or lightheadedness

Management involves adjusting the vest fit or frequency settings and monitoring for any adverse effects.

Benefits

The benefits of MCWO include:

• Improved mucus clearance
• Enhanced lung function
• Reduced frequency of respiratory infections
• Relief from symptoms like coughing and shortness of breath Most patients notice benefits within a few sessions, but continuous use is often needed for lasting results.

Recovery

There is no significant recovery period needed after MCWO. Patients can typically resume normal activities immediately. Follow-up may include regular sessions as recommended by a healthcare provider.

Alternatives

Other treatment options include:

• Physiotherapy techniques like chest physiotherapy (CPT)
• Positive Expiratory Pressure (PEP) therapy
• Airway clearance devices such as flutter valves
• Medications like mucolytics or bronchodilators Each alternative has its own pros and cons in terms of effectiveness, convenience, and patient preference.

Patient Experience

During the procedure, patients may feel rhythmic vibrations on their chest, which can cause a tickling sensation. It is generally comfortable, but some may experience increased coughing. Pain is rare, and comfort measures can include adjusting the pressure settings or pausing the session if needed.