Symmetrical-Waveform High-Frequency Oscillation Increases Artificial Mucus Flow Without Changing Basal Mucus Transport in In Vitro Ovine Trachea

Abstract

The efficacy of symmetrical-waveform high-frequency oscillating (HFO) air flow for airway secretion clearance is controversial and debated in the literature. We conducted in vitro experiments with ovine tracheae to investigate the effects of symmetrical-waveform HFO on tracheal transport of artificial mucus. We mounted each trachea as an intact tube, with a 15(o) head-down tilt, infused artificial mucus (10 mL over one hour) at the caudal end of the trachea, and measured mucus-transport velocity as the time between the beginning of infusion and the first appearance of artificial mucus over 2 near-infrared sensors at the rostral end of the trachea and by measuring the amount of mucus emerging. In a second series of experiments we opened each trachea flat and with video microscopy we measured the transport velocity of plaques over the endogenous mucus sheet. In the intact-trachea preparation, HFO at 20 Hz and 50 cm H(2)O increased mucus-transport velocity from 5.8 mm/min to 7.8 mm/min. HFO led to nearly half the artificial mucus being cleared during the infusion period. In the opened-trachea experiments the mean control transport velocity was 8.7 mm/min, and HFO, at 14 Hz or 20 Hz (and 50 cm H(2)O), did not significantly alter that velocity. Symmetrical-waveform HFO increases mucus-transport velocity and mucus clearance when a thick layer of mucus is present. This may be important when considering the mechanisms of mucus clearance and using HFO for secretion clearance.