A Comparison of Cough Assistance Techniques in Patients with Respiratory Muscle Weakness.
10.3349/ymj.2016.57.6.1488
- Author:
Sun Mi KIM
1
;
Won Ah CHOI
;
Yu Hui WON
;
Seong Woong KANG
Author Information
1. Department of Rehabilitation Medicine, Incheon Workers' Compensation Hospital, Incheon, Korea.
- Publication Type:Original Article
- Keywords:
Neuromuscular disease;
peak cough flow;
cough augmentation;
mechanical in-exsufflator
- MeSH:
Cough*;
Female;
Humans;
Insufflation;
Male;
Neuromuscular Diseases;
Respiratory Muscles*
- From:Yonsei Medical Journal
2016;57(6):1488-1493
- CountryRepublic of Korea
- Language:English
-
Abstract:
PURPOSE: To assess the ability of a mechanical in-exsufflator (MI-E), either alone or in combination with manual thrust, to augment cough in patients with neuromuscular disease (NMD) and respiratory muscle dysfunction. MATERIALS AND METHODS: For this randomized crossover single-center controlled trial, patients with noninvasive ventilator-dependent NMD were recruited. The primary outcome was peak cough flow (PCF), which was measured in each patient after a cough that was unassisted, manually assisted following a maximum insufflation capacity (MIC) maneuver, assisted by MI-E, or assisted by manual thrust plus MI-E. The cough augmentation techniques were provided in random order. PCF was measured using a new device, the Cough Aid. RESULTS: All 40 enrolled participants (37 males, three females; average age, 20.9±7.2 years) completed the study. The mean (standard deviation) PCFs in the unassisted, manually assisted following an MIC maneuver, MI-E-assisted, and manual thrust plus MI-E-assisted conditions were 95.7 (40.5), 155.9 (53.1), 177.2 (33.9), and 202.4 (46.6) L/min, respectively. All three interventions significantly improved PCF. However, manual assistance following an MIC maneuver was significantly less effective than MI-E alone. Manual thrust plus MI-E was significantly more effective than both of these interventions. CONCLUSION: In patients with NMD and respiratory muscle dysfunction, MI-E alone was more effective than manual assistance following an MIC maneuver. However, MI-E used in conjunction with manual thrust improved PCF even further.
