Kazuto Kikuchi1, Masahiro Satake2, Yoshino Terui2, Yusuke Kimoto3, Satomi Iwasawa4, Yutaka Furukawa5. 1. Department of Rehabilitation, Akita National Hospital, National Hospital Organization. 2. Department of Physical Therapy, Graduate School of Health Sciences, Akita University. 3. Department of Physical Therapy, Akita Rehabilitation Core Academy, School Corporation. 4. Department of Rehabilitation, Akita Prefectual Center for Rehabilitation and Psychiatric Medicine. 5. Department of Rehabilitation, Akita City Hospital.
Abstract
PURPOSE: Mechanically assisted coughing (MAC) is an airway clearance method in which the thorax/abdomen is compressed in synchronization with mechanical insufflation-exsufflation (MI-E). MAC can be performed with manual assistance at the upper thorax (MAC-UT), lower thorax (MAC-LT), and upper thorax + abdomen (MAC-UT/A). This study aimed to determine the most effective approach under different conditions (air stacking or tracheostomy) in patients with neuromuscular disorders (NMDs). METHODS: The study included 34 patients with NMDs. The patients were categorized into air stacking group (n=15), no air stacking group (n=9), and tracheostomy/tracheostomy positive-pressure ventilation (TPPV) group (n=10). RESULTS: In each group, the cough peak flow (CPF) at 75% of the forced vital capacity (V̇75), V̇50, V̇25, and V̇10 were investigated during the approaches. In the air stacking group, the CPF was higher with MAC-UT, MAC-LT, and MAC-UT/A than with MI-E (p < 0.05). Additionally, V̇75 was higher with MAC-LT and MAC-UT/A than with MI-E (p < 0.05 and p < 0.01, respectively). In the no air stacking group, V̇75 was higher with MAC-UT/A than with MI-E (p < 0.05). In the tracheotomy/TPPV group, there were no significant differences. CONCLUSIONS: MAC approaches, especially MAC-LT and MAC-UT/A, are preferred in air stacking patients. However, in tracheostomy/TPPV patients, the CPF might not increase with MAC. 2019, JAPANESE PHYSICAL THERAPY ASSOCIATION.
PURPOSE: Mechanically assisted coughing (MAC) is an airway clearance method in which the thorax/abdomen is compressed in synchronization with mechanical insufflation-exsufflation (MI-E). MAC can be performed with manual assistance at the upper thorax (MAC-UT), lower thorax (MAC-LT), and upper thorax + abdomen (MAC-UT/A). This study aimed to determine the most effective approach under different conditions (air stacking or tracheostomy) in patients with neuromuscular disorders (NMDs). METHODS: The study included 34 patients with NMDs. The patients were categorized into air stacking group (n=15), no air stacking group (n=9), and tracheostomy/tracheostomy positive-pressure ventilation (TPPV) group (n=10). RESULTS: In each group, the cough peak flow (CPF) at 75% of the forced vital capacity (V̇75), V̇50, V̇25, and V̇10 were investigated during the approaches. In the air stacking group, the CPF was higher with MAC-UT, MAC-LT, and MAC-UT/A than with MI-E (p < 0.05). Additionally, V̇75 was higher with MAC-LT and MAC-UT/A than with MI-E (p < 0.05 and p < 0.01, respectively). In the no air stacking group, V̇75 was higher with MAC-UT/A than with MI-E (p < 0.05). In the tracheotomy/TPPV group, there were no significant differences. CONCLUSIONS: MAC approaches, especially MAC-LT and MAC-UT/A, are preferred in air stacking patients. However, in tracheostomy/TPPV patients, the CPF might not increase with MAC. 2019, JAPANESE PHYSICAL THERAPY ASSOCIATION.
Authors: J Ignacio de Ulíbarri; A González-Madroño; N G P de Villar; P González; B González; A Mancha; F Rodríguez; G Fernández Journal: Nutr Hosp Date: 2005 Jan-Feb Impact factor: 1.057
Authors: Tiina Andersen; Astrid Sandnes; Anne Kristine Brekka; Magnus Hilland; Hege Clemm; Ove Fondenes; Ole-Bjørn Tysnes; John-Helge Heimdal; Thomas Halvorsen; Maria Vollsæter; Ola Drange Røksund Journal: Thorax Date: 2016-05-12 Impact factor: 9.139