Pulmonary therapy
Oscillation and Lung Expansion Therapy as Rescue Airway Clearance in Critically Ill Adults: A Case Series
By Boechler N, Smith C, Huntley K and 1 others.
Abstract
Introduction
Retained airway secretions and lobar collapse are common in hospitalized adults with advanced lung disease. Conventional airway clearance depends on respiratory effort, requiring both an adequate inspiratory volume and sufficient expiratory airflow, and on cough strength, and therefore fails most often in the patients who need it most. Oscillation and lung expansion (OLE) therapy delivers continuous positive expiratory pressure (CPEP), continuous high-frequency oscillation (CHFO), and aerosolized medication in a single 10-min treatment, but reported experience is largely confined to postoperative prophylaxis and the home setting.
Methods
We describe six consecutive adults (aged 18-77 years) treated with OLE (Volara system) at a Canadian tertiary center between March 2023 and April 2026, after conventional airway clearance had failed or after escalation to near-maximal noninvasive respiratory support. Feasibility (delivery of OLE as prescribed at the prevailing level of respiratory support) and tolerability (absence of adverse events or discontinuation for intolerance) were assessed retrospectively.