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British Journal of Anaesthesia, 2001, Vol. 87, No. 3 441-446
© 2001 The Board of Management and Trustees of the British Journal of Anaesthesia

Clinical Investigations

Combination of external chest wall oscillation with continuous positive airway pressure

S. E. Scholz, J. Sticher*, G. Häufler, M. Müller, O. Böning and G. Hempelmann

Department of Anaesthesiology and Intensive Care Medicine, Justus-Liebig-University, Rudolf-Buchheim-Strasse 7, D-35385 Giessen, Germany*Corresponding author

We studied the effects of continuous positive airway pressure (CPAP) on pulmonary gas exchange during external chest wall oscillation (ECWO), and the relationship with obesity, in nine patients with normal body weight (group ‘N’) and 10 obese patients (group ‘O’). During ECWO with CPAP 5, PaCO2 decreased in group ‘O’ (6.0 (SD 0.8) to 5.6 (0.5) kPa, P<0.05), whereas it increased in group ‘N’ at all levels (P<0.01). Arterial PO2 (P<0.001) was greater and PaCO2 (P<0.01) less in group ‘N’ during CPPV and ECWO plus CPAP. We also compared the haemodynamic effects of ECWO plus CPAP with those of continuous positive pressure ventilation (CPPV). ECWO plus CPAP and CPPV were applied for 30 min to 6 ASA III patients. Cardiac output (CI 2.7 (0.5) vs 2.1 (0.2) litre min–1 m–2, P<0.05) and stroke volume (SVI 49 (9) vs 32 (6) ml m–2, P<0.05) were greater during ECWO plus CPAP than with CPPV. ECWO is less effective in obese individuals than in those with normal body weight, and the effect of CPAP in overweight individuals is small.

Br J Anaesth 2001; 87: 441–6


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