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The Rigid Tube as an Alternative in Controlling the Problematic Airway
Published on: June 6, 2020
External control of exhalation for cough assistance: a method for patients with glottis dysfunction and/or
Sang Chul Lee1, Jung Hyun Park, Seong-Woong Kang
1Department of Physical Medicine and Rehabilitation, Myongji Hospital, Kwandong University College of Medicine, Koyang, Kyunggi, Korea.
Objective:
To investigate the effectiveness of our method of assisting a cough by mimicking the functions of the glottis in patients with bulbar muscle weakness or paralysis and/or those who had a tracheostomy tube.
Design:
Before-after trial.
Setting:
University rehabilitation hospital.
Participants:
Patients (N=35) with bulbar muscle weakness or paralysis and/or those who had a tracheostomy tube.
Interventions:
Not applicable.
Main Outcome Measures:
The unassisted peak cough flow (PCF), the assisted PCF, and the assisted PCF with the external control method mimicking glottis function by an end-inspiratory external closure of the airways.
Results:
Of the 35 patients, 13 were tracheostomized cervical cord injury patients, 11 were neuromuscular disease (NMD) patients with glottis dysfunction only, and 11 were NMD patients with a tracheostomy and glottis dysfunction. Assisted PCF with the external control method were higher than unassisted PCF and/or assisted PCF in all patients. Assisted PCF with the external control methods were measured in all of the patients even when the unassisted PCFs and/or assisted PCFs could not be measured. For patients with measurable assisted PCFs, the assisted PCF with the external control methods were significantly higher than the assisted PCFs.
Conclusions:
We showed the effectiveness of our method of assisting a cough by external control of the glottis in patients with bulbar muscle weakness or paralysis and/or those who had a tracheostomy tube who cannot effectively cough with the help of existing cough assistance methods.
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