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.
Keywords
List of abbreviations:
APCF (assisted peak cough flow), ASIA (American Spinal Injury Association), PCF (peak cough flow), UPCF (unassisted peak cough flow)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: March 19, 2016
Footnotes
Supported by a faculty research grant from the Yonsei University College of Medicine for 2014 (grant no. 6-2014-0015).
Disclosures: S.-W.K. holds a patent for a device for assisting cough and lung expansion in patients with paralytic bulbar musculature (patent no. 100516324). The other authors have nothing to disclose.
Identification
Copyright
© 2016 by the American Congress of Rehabilitation Medicine
