Resonant frequency does not predict high-frequency chest compression settings that maximize airflow or volume

High-frequency chest compression (HFCC) is a therapy for cystic fibrosis (CF). We hypothesized that the resonant frequency (f(res)), as measured by impulse oscillometry, could be used to determine what HFCC vest settings produce maximal airflow or volume in pediatric CF patients. In 45 subjects, we studied: f(res), HFCC vest frequencies that subjects used (f(used)), and the HFCC vest frequencies that generated the greatest volume (f(vol)) and airflow (f(flow)) changes as measured by pneumotachometer. Median f(used) for 32 subjects was 14 Hz (range, 6-30). The rank order of the three most common f(used) was 15 Hz (28%) and 12 Hz (21%); three frequencies tied for third: 10, 11, and 14 Hz (5% each). Median f(res) for 43 subjects was 20.30 Hz (range, 7.85-33.65). Nineteen subjects underwent vest-tuning to determine f(vol) and f(flow). Median f(vol) was 8 Hz (range, 6-30). The rank order of the three most common f(vol) was: 8 Hz (42%), 6 Hz (32%), and 10 Hz (21%). Median f(flow) was 26 Hz (range, 8-30). The rank order of the three most common f(flow) was: 30 Hz (26%) and 28 Hz (21%); three frequencies tied for third: 8, 14, and 18 Hz (11% each). There was no correlation between f(used) and f(flow) (r(2) = -0.12) or f(vol) (r(2) = 0.031). There was no correlation between f(res) and f(flow) (r(2) = 0.19) or f(vol) (r(2) = 0.023). Multivariable analysis showed no independent variables were predictive of f(flow) or f(vol). Vest-tuning may be required to optimize clinical utility of HFCC. Multiple HFCC frequencies may need to be used to incorporate f(flow) and f(vol).