High frequency chest wall oscillation plus Mechanical In-Exsufflation in Duchenne muscular dystrophy with respiratory complications related to pandemic Influenza A/H1N1 [Oscilação de alta freqüência da parede torácica associado a in-exsuflação mecânica na distrofia muscular de Duchenne com complicações respiratórias relacionadas com o vírus pandémico da gripe A/H1N1]

Two young boys with duchenne muscular dystrophy,who had contracted 2009 pandemic influenza a/h1n1 (ph1n1),had been treated with antibiotics and steroids without significant improvement. one of them showed severe scoliosis. after hospitalization chest ct scan revealed extensive pulmonary bilateral segmental atelectasis. their clinical and radiological findings rapidly improved when a sequential respiratory physiotherapy protocol was adopted that consisted of the application of multiple sessions of high-frequency chest wall oscillations,each one followed by mechanically assisted coughing manoeuvres. the protocol was well tolerated,effective,easy to apply and special positioning was not required. fifteen days after treatment initiation both patients clinically recovered. this treatment can be very helpful for neuromuscular patients,particularly when scoliosis prevents conventional respiratory physiotherapy. © 2010 published by elsevier españa,s.l. on behalf of sociedade portuguesa de pneumologia. all rights reserved.