Lori Alma, RN, is a registered nurse and cystic fibrosis expert who assists families in a Florida Department of Health program for special needs children.
Susan Russell, MD is a board-certified pulmonologist and currently the Medical Director for Northwestern Memorial Hospital's Inpatient Pulmonary Unit.
Many people with cystic fibrosis (CF) and other medical conditions use high-frequency chest wall oscillation (HFCWO) vests, otherwise known as airway clearance systems, as part of their daily airway clearance routine.
If you are considering using a therapy vest, you undoubtedly have some questions that you’ll want to be answered before you decide whether HFCWO is right for you or your child. This article addresses some of the most frequently asked questions (FAQ's) asked about these systems.
HFCWO vests look similar to water-sport life jackets. They are made out of soft, flexible material that is similar to the material used for blood pressure cuffs. The vest has one or two large, flexible plastic hoses attached to it that connect to a small machine. Two well-known brands of these vests include:
A newer type of vest features built-in individual oscillating mechanical modules that allow for freedom of movement to travel without the restrictive hoses or heavy generators:
The goals of HFCWO treatment are the same as with any other airway clearance technique—to break up mucus and help bring it to the upper airways, where it can be coughed out or removed by suction. The machine connected to the vest is an air compressor that delivers bursts of air to rapidly inflate and deflate the vest about 25 times per second. This creates gentle pressure and vibration on the chest, which does three things:
There is no minimum age requirement for HFCWO therapy. Generally, once a child’s chest measurement is big enough for the vest to fit properly, he or she can begin using the vest.
These systems can be expensive or hard to find. New models of the vest can cost between $15,000 and $20,000, and may not always be covered by insurance. For example, most insurance companies require certain criteria to be met before they agree to pay for the vest. For example, some insurers may want documentation of frequent respiratory infections or evidence that other airway clearance techniques have been attempted with limited or no success.
For some, the vest offers a great alternative or addition to manual chest physiotherapy (CPT), but it’s not necessarily the best option for everyone. The decision to use HFCWO therapy or not is a choice based on personal preference and healthcare provider recommendations (see chart below).
HFCWO vests are only available by prescription. If you are considering using the vest, talk to your healthcare provider or CF treatment center team.
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Cystic Fibrosis Foundation. High-Frequency Chest Wall Oscillation (the Vest).
AffloVests. What is High Frequency Chest Wall Oscillation?
Medafore Inc. Hill-Rom TheVest 105 Airway Clearance Systems.
By Lori Alma Lori Alma, RN, is a registered nurse and cystic fibrosis expert who assists families in a Florida Department of Health program for special needs children.
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