Journal
EUROPEAN RESPIRATORY JOURNAL
Volume 21, Issue 3, Pages 502-508Publisher
EUROPEAN RESPIRATORY SOC JOURNALS LTD
DOI: 10.1183/09031936.03.00048102
Keywords
noninvasive positive pressure ventilation; paediatrics; physiotherapy; respiratory muscle tests
Categories
Ask authors/readers for more resources
Adults and children with neuromuscular disease exhibit weak cough and are susceptible to recurrent chest infections, a major cause of morbidity and mortality. Mechanical insufflation/exsufflation may improve cough efficacy by increasing peak cough flow. It was hypothesised that mechanical insufflation/exsufflation would produce a greater increase in peak cough flow than other modes of cough augmentation. The acceptability of these interventions was also compared. Twenty-two patients aged 10-56 yrs (median 21 yrs) with neuromuscular disease and 19 age-matched controls were studied. Spirometry was performed and respiratory muscle strength measured. Peak cough flow was recorded during maximal unassisted coughs, followed in random order by coughs assisted by physiotherapy, noninvasive ventilation, insufflation and exsufflation, and exsufflation alone. Subjects rated strength of cough, distress and comfort on a visual analogue scale. In the neuromuscular disease group, mean+/-SD forced expiratory volume in one second was 0.8+/-0.6 L(.)s(-1), forced vital capacity 0.9+/-0.8 L, maximum inspiratory pressure 25+/-16 cmH(2)O, maximum expiratory pressure 26+/-22 cmH(2)O and unassisted peak cough flow 169+/-90 L(.)min(-1). The greatest increase in peak cough flow, was observed with mechanical insufflation/exsufflation at 235+/-111 L(.)min(-1) (p<0.01). All techniques showed similar patient acceptability. Mechanical insufflation/exsufflation produces a greater increase in peak cough flow than other standard cough augmentation techniques in adults and children with neuromuscular disease.
Authors
I am an author on this paper
Click your name to claim this paper and add it to your profile.
Reviews
Recommended
No Data Available