High-Frequency Chest-Wall Compression, Patient Safety, and the <i>n</i>-of-1 Construct

In this issue of RESPIRATORY CARE, Allan and colleagues report on the safety of high-frequency chest-wall compression (HFCWC, with The Vest, Hill-Rom, St Paul, Minnesota) in the 48 hours following thoracic surgery.1 The study is long overdue and is the first examination of the general safety and hemodynamic consequences of HFCWC in a patient population that may be predisposed to hemodynamic compromise. Allan et al give us a well designed study that effectively tested the general safety and hemodynamic consequences of HFCWC in the early postoperative course of the thoracic-surgery patient. There were no major adverse events, which is noteworthy, given the anecdotal mythology that seems to hover in the mist concerning HFCWC and the cardiothoracic-surgery patient. Perhaps the most important finding was that patients who expressed a preference for either HFCWC or conventional manual chest physiotherapy preferred HFCWC by more than two to one.