307 691

Cited 0 times in

Clinical implication of artificial glottic closure for air-stacking exercise in patients with glottis dysfunction

Other Titles
 성문기능 장애 환자의 공기누적운동에서 인위적 성문폐쇄의 임상적 의미 
 Dept. of Rehabilitation Medicine (재활의학교실) 
Issue Date
Dept. of Medicine/석사

[영문]Objective: Patients with neuromuscular disease can have severe inspiratory and expiratory muscle weakness that diminishes vital capacity and lung compliance. Atelectasis and inability to effectively cough out airway secretions are the main cause of respiratory failure and mortality. Therefore, air-stacking exercise which insufflates the lung to its maximal capacity is mandatory to maintain pulmonary compliance. However, neuromuscular patients with bulbar musculature weakness or indwelling tracheostomy cannot induce glottic opening and closure. For these patients, we developed a method which enables air stacking exercise by mimicking the glottis function. Method: 40 patients with bulbar muscle weakness or indwelling tracheostomy were recruited. 26 were amyotrophic lateral sclerosis(ALS) patients, and 14 were tetraplegic patients due to cervical spinal cord injury(SCI). T-shaped device is mainly composed of the connection and the control part. One-way valve is installed to the connection part to provide extra volume of air via a manual resuscitator bag, which also prevents air leakage. The control part is designed to artificially modulate glottic opening and closure. In order to confirm the utility of external control device vital capacity(VC), maximum insufflation capacity(MIC), and maximum insufflation capacity with a device(MIC-device) were measured. Results: For the 32 patients, MIC was not measurable initially. However, with help of the method which enables air stacking exercise, MIC-device was successfully measured for all patients. Mean MIC-device value was 1701.9±660.5ml. For the remaining 8 patients, MIC was measurable even without the device, but mean MIC and MIC-device values were 1073.8±242.4ml, 1847.5±233.7ml respectively. MIC-device of the patients was significantly higher than MIC alone. Conclusion: The new method enables air staking, which is mandatory for lung expansion. It also makes it possible to maintain or even improve pulmonary compliance, which eventually prevents lethal pulmonary complications.
Files in This Item:
T011012.pdf Download
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Rehabilitation Medicine (재활의학교실) > 2. Thesis
Yonsei Authors
Kim, Dong Hyun(김동현)
사서에게 알리기


Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.