Option for People With COPD: High-Frequency Chest Wall Oscillation Vests

During a recent conversation with a home healthcare specialist, I discovered that high-frequency chest wall oscillation (HFCWO) vests are now accessible for certain people managing COPD. But what exactly are they, and how could they potentially enhance your well-being? Here's what I learned from my conversation.

What is a high-frequency chest wall oscillation vest?

They resemble somewhat inflated life jackets, these high-frequency chest wall oscillation (HFCWO) vests. Simply slip one on, like putting on a life jacket, and zip it up. It's surprisingly lightweight, typically weighing only 5 to 10 pounds, depending on the required size. The vest is equipped with a handheld remote control, so you can easily activate it with the push of a button.

Unlike their predecessors, which required tethering to a bed via a table-bound device, these newer vests afford you greater freedom. You're not confined to a bed or chair. Instead, you can move about freely, whether you are cooking, cleaning, or taking a stroll.

Moreover, newer vests are designed with quieter operation in mind. They hum softly, akin to the gentle purr of a contented cat rather than the intrusive whir of older models.

This quieter operation ensures minimal disruption to your daily activities. You can comfortably engage in conversation, listen to music, or simply enjoy moments of peace without disturbance.

How do HFCWO vests work?

As COPD advances, more alveoli break apart, leading to trapped air in the lungs and hyperinflation. This is a perpetual state resembling a deep breath, even during exhalation. This hyperinflation puts pressure on the diaphragm, causing it to flatten.

The diaphragm is crucial for deep breathing and coughing. When it is flattened, it becomes challenging to effectively clear secretions. This leads to a buildup of mucus in the airways and potential mucus plugging, further complicating breathing.

Moreover, this stagnant mucus creates an environment ripe for bacterial growth, increasing the risk of pneumonia and exacerbations of COPD.

Therefore, the goal of an HFCWO vest is to help you move and expel mucus. It does so by vibrating your chest wall. These vests are specifically made to clear mucus from all airways. Ultimately, this can help you clear secretions, ease breathing, enhance quality of life, and reduce the frequency of exacerbations and hospitalizations.¹

Interestingly, some patients have described the sensation as feeling like a gentle massage. The controller allows you to customize both the intensity and duration of the vibration to suit your preference or your doctor's recommendation.

Who should use vest therapy?

To qualify for an HFCWO vest, depending on your pulmonologist's recommendations, you usually have to have a diagnosis of severe COPD or bronchiectasis. You likely also need to have tried other treatments first. These treatments may include medicines such as rescue medicine (albuterol) and muscarinic antagonist (ipratropium bromide, Spiriva^®). You may also have tried using a device such as a flutter valve or an Acapella.^1,2

These treatments are specifically approved for people with severe COPD and other pulmonary diseases. People with COPD often experience an overproduction of secretions that can become increasingly difficult to clear as the disease progresses, particularly in its severe stages.

If you have tried other treatments for a certain length of time, they have failed to prevent flare-ups, and you continue to require hospital visits (either to the ER or as an inpatient), you may qualify for an HFCWO vest.

Have you had the chance to try one of these vests? If so, how was your experience? If not, do you believe you could benefit from one? If you think it could be helpful, discussing it with your COPD doctor might be a valuable next step.