An 18-year-old patient with muscular dystrophy is receiving treatment for recurrent pneumonia and atelectasis. What should a respiratory therapist recommend in addition to HFCWO?

In the context of an 18-year-old patient with muscular dystrophy who is experiencing recurrent pneumonia and atelectasis, it is crucial to promote effective airway clearance to reduce pulmonary complications. The recommended additional treatment of mechanical insufflation/exsufflation is particularly beneficial for this patient population.

Muscular dystrophy can lead to decreased muscle strength, including the muscles involved in cough. Mechanical insufflation/exsufflation, often referred to as a cough assist, aids in mimicking a natural cough by delivering a positive pressure breath followed by a rapid shift to negative pressure. This helps mobilize secretions more effectively than many other ventilation methods, providing the patient with the necessary support to expel mucus.

This approach is especially advantageous for patients with neuromuscular disorders as it compensates for their weakened ability to generate an effective cough. By enhancing airway clearance, it directly addresses the patient's risk for atelectasis and recurrent pneumonia, making it a suitable recommendation alongside the already prescribed high-frequency chest wall oscillation (HFCWO).

In contrast, while vibratory PEP and incentive spirometry can assist in maintaining lung volume and promoting lung expansion, they may not be as effective for patients with significant weakness in respiratory muscles. Manual chest physiotherapy (C