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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.
These assessments most frequently included neurological status, Rapid Shallow Breathing index (RSBi), occlusion pressure during initial 100 ms of inspiration (P0.1), Negative Inspiratory Force (NIF), peak cough flow (PCF) and secretion load.
The oral temperature, self-reported symptoms, cough volumes, and peak cough flow rates of all subjects are shown in Table 3. Influenza-positive subjects reported more symptoms overall than influenza-negative subjects, but there was no clear relationship between any of the clinical parameters and the amount of influenza RNA contained in the cough-generated aerosols.
Their results for peak cough flow rates revealed that voluntary cough flow rate and the maximal cough flow rate achieved in any one effort was significantly higher for voluntary cough than for reflex cough.
Trebbia et al. [ 26] reported that MIP had a higher correlation with peak cough flow than MEP in patients with neuromuscular disorders.
Combining the three risk factors of decreased peak cough flow, increased sputum volume, and abnormal neurological assessment had a synergistic effect.
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Previous studies and guidelines have also suggested that maximal expiratory pressure, peak cough flows, arterial blood gases, and upper airway endoscopy may be useful in the decannulation decision-making process, although these factors require special equipment and expertise and are more complicated than the simple bedside criteria employed in our study [ 15- 17].
Fig. 2 Receiver operating characteristic (ROC) curves for data recorded before extubation: peak cough expiratory flow (PCEF), peak expiratory flow (PEF), forced vital capacity (FVC), slow VC, and maximal inspiratory (MIP) and expiratory (MEP) mouth pressures.
Fig. 3 Receiver operating characteristic (ROC) curves for data recorded after extubation: peak cough expiratory flow (PCEF), peak expiratory flow (PEF), forced vital capacity (FVC), slow VC, and maximal inspiratory (MIP) and expiratory (MEP) mouth pressures AUC, area under the ROC curve.
To assess cough peak flow in patients with frequent infective exacerbations of COPD.
To assess the acute effects of air stacking on cough peak flow (CPF) and chest wall compartmental volumes of persons with amyotrophic lateral sclerosis (ALS) versus healthy subjects positioned at 45° body inclination.
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