Ann Rehabil Med.  2018 Dec;42(6):833-837. 10.5535/arm.2018.42.6.833.

Improvement of Peak Cough Flow After the Application of a Mechanical In-exsufflator in Patients With Neuromuscular Disease and Pneumonia: A Pilot Study

• Jung JH
• Oh HJ
• Lee JW
• Suh MR
• Park J
• Choi WA
• Kang SW

• KMID: 2448904
• DOI: http://doi.org/10.5535/arm.2018.42.6.833

Abstract

OBJECTIVE
To investigate and demonstrate persistent increase of peak cough flow after mechanical in-exsufflator application, in patients with neuromuscular diseases and pneumonia.
METHODS
A mechanical in-exsufflator was applied with patients in an upright or semi-upright sitting position (pressure setting, +40 and −40 cmH2O; in-exsufflation times, 2-3 and 1-2 seconds, respectively). Patients underwent five cycles, with 20-30 second intervals to prevent hyperventilation. Peak cough flow without and with assistive maneuvers, was evaluated before, and 15 and 45 minutes after mechanical in-exsufflator application.
RESULTS
Peak cough flow was 92.6 L/min at baseline, and 100.4 and 100.7 L/min at 15 and 45 minutes after mechanical in-exsufflator application, respectively. Assisted peak cough flow at baseline, 15 minutes, and 45 minutes after mechanical in-exsufflator application was 170.7, 179.3, and 184.1 L/min, respectively. While peak cough flow and assisted peak cough flow increased significantly at 15 minutes after mechanical in-exsufflator application compared with baseline (p=0.030 and p=0.016), no statistical difference was observed between 15 and 45 minutes.
CONCLUSION
Increased peak cough flow after mechanical in-exsufflator application persists for at least 45 minutes.

Keyword

Mechanical in-exsufflator; Neuromuscular diseases; Pneumonia; Peak cough flow

MeSH Terms

Cough*
Humans
Hyperventilation
Neuromuscular Diseases*
Pilot Projects*
Pneumonia*

Figure

• 

  Fig. 1. (A) PCF and (B) APCF before and after mechanical in-exsufflator application. Each graph shows the mean (dot) and standard error (bar). PCF, peak cough flow; APCF, assisted peak cough flow.

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