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Clinical Implications of Assisted Peak Cough Flow Measured With an External Glottic Control Device for Tracheostomy Decannulation in Patients With Neuromuscular Diseases and Cervical Spinal Cord Injuries: A Pilot Study.

Authors
 Seong-Woong Kang  ;  Won Ah Choi  ;  Yu Hui Won  ;  Jang Woo Lee  ;  Hoo Young Lee  ;  Dong Jin Kim 
Citation
 ARCHIVES OF PHYSICAL MEDICINE AND REHABILITATION, Vol.97(9) : 1509-1514, 2016 
Journal Title
 ARCHIVES OF PHYSICAL MEDICINE AND REHABILITATION 
ISSN
 0003-9993 
Issue Date
2016
MeSH
Adult ; Aged ; Cervical Cord ; Cough/physiopathology* ; Device Removal/methods* ; Diagnostic Techniques and Procedures/instrumentation* ; Female ; Glottis ; Hospitals, University ; Humans ; Male ; Middle Aged ; Neuromuscular Diseases/rehabilitation* ; Pilot Projects ; Spinal Cord Injuries/rehabilitation* ; Tracheostomy/methods* ; Young Adult
Keywords
Cough ; Glottis ; Neuromuscular diseases ; Rehabilitation ; Spinal cord injuries ; Tracheostomy
Abstract
OBJECTIVE: To investigate the clinical usefulness and significance of an external control device substituting for glottic function in determining the feasibility of decannulation in tracheostomized patients with neuromuscular diseases and cervical spinal cord injuries whose assisted peak cough flow (APCF) was unmeasurable or <160L/min. DESIGN: Before-after trial. SETTING: Inpatient setting in a university hospital. PARTICIPANTS: Tracheostomized patients (N=16; 11 with neuromuscular diseases and 5 with cervical spinal cord injuries) were recruited. INTERVENTIONS: Unassisted peak cough flow (UPCF) and APCF were measured with and without an external glottic control device. Among patients whose APCF without the device was <160L/min, if their APCF with the device was measured as ≥160L/min, they were decannulated. After decannulation, UPCF and APCF were measured again. MAIN OUTCOME MEASURES: APCF with and without an external glottic control device as well as APCF after decannulation. RESULTS: After successful decannulation, APCFs were greater than or equal to those measured with the device before decannulation. No patients underwent intubation or retracheostomy, and there were no respiratory complications. CONCLUSIONS: The external glottic control device substituting for innate glottic function is beneficial for determining tracheostomy decannulation. It provides an objective and accurate APCF. It is particularly helpful for patients whose APCF is ≥160L/min while using the device, even if APCF is <160L/min without this device.
Full Text
http://www.sciencedirect.com/science/article/pii/S0003999316001659
DOI
10.1016/j.apmr.2016.02.023
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Rehabilitation Medicine (재활의학교실) > 1. Journal Papers
Yonsei Authors
Kang, Seong Woong(강성웅) ORCID logo https://orcid.org/0000-0002-7279-3893
Choi, Won Ah(최원아) ORCID logo https://orcid.org/0000-0003-0403-8869
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/147154
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