CNE Article: Pain after lung transplant: high-frequency chest wall oscillation vs chest physiotherapy.
Esguerra-Gonzalez A, Ilagan-Honorio M, et al.American Journal of Critical Care 2013; 22(2): 115-124.
Aims
To compare the effect of high frequency chest wall oscillation (HFCWO) and chest physiotherapy (CPT) on measures of pain and preference in adult lung transplant patients.
Interventions
Participants received either CPT during the first half of postoperative day 3 followed by HFCWO for the second half of postoperative day 3, or HFCWO during the first half of post operative day 3 followed by CPT for the second half of the same day.
Participants
46 single lung transplant or double lung transplant patients aged 18-80 years, fluent in English and hemodynamically stable.
Outcomes
The outcome measures included pain and preference; measured on a verbal numeric rating scale (an edited version of the Chest Physiotherapy Satisfaction Survey).
Follow-up
Immediately after treatment and 15 minutes after treatment.
CET Conclusions
This trial assesses the subjective and objective benefits of HFCWO versus standard chest physiotherapy in lung transplant recipients in the early post-operative period. Whilst there is a greater reduction in pain scores seen with HWCWO treatment, this difference loses significance when concomitant pain medication and transplant type are included in the analysis model. Furthermore, the study is underpowered (the power calculation is based upon a power of only 70%) and missing data means that analysis of outcomes at two time-points was not possible. Interestingly, despite the differences in objective pain scores there were no overall differences in subjective assessment of pain, preference or effectiveness between the two treatments. No clinical data regarding pulmonary complications related to the two treatments is reported.
Data analysis
Available case analysis
Trial registration
Not reported.