Life jacket that can unblock your airways
AN INFLATABLE vest may be a new way to treat breathing problems. The vests, which look like life jackets, have the effect of up to 18,000 coughs in a 20-minute session, and have been shown to help with a number of lung conditions.
These include the genetic condition cystic fibrosis as well as chronic obstructive pulmonary disease (COPD), an umbrella term for lung diseases such as emphysema and chronic bronchitis.
New research presented at the recent annual meeting of the American Thoracic Society in San Francisco found the vests can also help people with bronchiectasis, a chronic condition where the airways of the lungs become abnormally widened.
All these conditions are characterised by a build-up of phlegm or a thick, sticky mucus in the airways, which makes symptoms such as breathlessness, wheezing and coughing worse. Left alone, this congestion can cause infections.
The inflatable vests, or high-frequency chest wall oscillation vests as they are known, effectively shake the chest to loosen this buildup from the airways.
They contain inflatable pockets that cover the chest area. A hose connects the vest to a device that sends pulses of air into the pockets, which inflate and deflate rapidly.
The theory is that the cycle of inflation and deflation compresses and releases the chest wall, pushing a gust of air through the airways, just like a cough would. (The patient only feels it as a steady, gentle vibration.)
Patients are told to cough every five minutes during a session to remove large quantities of mucus. The vest compresses the chest 15 times a second.
It helps in two ways: the shaking movement pulls the sticky mucus from the airway walls; and it makes it thinner and easier to cough up.
The vest also increases the speed and clearance rate of the mucus because the continual shaking helps to transport secretions upward towards the mouth, where they can be coughed out or swallowed down into the stomach.
A recent study by the Baylor University in Texas in the U.S. found the vests halved the number of hospital admissions in patients with bronchiectasis.
The researchers, who analysed data from more than 2,000 patients, found the number who needed antibiotics also nearly halved, from 57.5 per cent to 29.9 per cent.
Patients felt much more in control of their condition, too.
Another U.S. study on 426 patients with breathing difficulties linked to neuromuscular diseases — those that affect the nerves which control the action of muscles — also showed that patients were much less likely to end up in hospital if they used the inflatable vests.
Researchers at St George’s Hospital in London have previously tested the vests on patients with COPD.
A study published in 2011 showed that after four weeks of daily use, patients had improved quality of life and reduced symptoms. Around 30 patients have been taking part in a further trial.
Commenting on the technology, Dr Richard Russell, a consultant respiratory physician at Southern Healthcare NHS Foundation Trust says: ‘These vests clearly have value in many conditions that cause excess mucus (such as bronchiectasis) or very sticky mucus (a characteristic of cystic fibrosis) or where a patient’s cough is not strong enough to be effective (as in neuromuscular diseases).
‘They may also help hospitalised patients with pneumonia or those who are in intensive care.
‘The technology will need further proof of its cost effectiveness.
‘However, if it can reduce admissions to intensive care then this new and exciting technology may have a role in every hospital on respiratory and post-surgical wards.’
MEANWHILE, hotter temperatures appear to worsen the symptoms of COPD, according to research published in the Annals of the American Thoracic Society.
U.S. researchers monitored 69 patients’ breathing during the summer months and found that as temperatures rose, so did their breathlessness, coughing and use of emergency inhalers. Exactly why is unclear.