scholarly journals Effect of manually assisted cough and mechanical insufflation on cough flow of normal subjects, patients with chronic obstructive pulmonary disease (COPD), and patients with respiratory muscle weakness

Thorax ◽  
2001 ◽  
Vol 56 (6) ◽  
pp. 438-444 ◽  
Author(s):  
P Sivasothy
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Muscle Weakness ◽  
Respiratory Muscle ◽  
Normal Subjects ◽  
Chronic Obstructive ◽  
Respiratory Muscle Weakness ◽  
Obstructive Pulmonary Disease

scholarly journals Effect of manually assisted cough and mechanical insufflation on cough flow of normal subjects, patients with chronic obstructive pulmonary disease (COPD), and patients with respiratory muscle weakness

Thorax ◽  
2001 ◽  
Vol 56 (6) ◽  
pp. 438-444
Author(s):  
P Sivasothy ◽  
L Brown ◽  
I E Smith ◽  
J M Shneerson
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Flow Rate ◽  
Peak Expiratory Flow Rate ◽  
Respiratory Muscle ◽  
Normal Subjects ◽  
Chronic Obstructive ◽  
Respiratory Muscle Weakness ◽  
Obstructive Pulmonary Disease ◽  
Expiratory Flow

BACKGROUNDIt has been suggested that cough effectiveness can be improved by assisted techniques. The effects of manually assisted cough and mechanical insufflation on cough flow physiology are reported in this study.METHODSThe physiological actions and patient self-assessment of manually assisted cough and mechanical insufflation were investigated in 29 subjects (nine normal subjects, eight patients with chronic obstructive pulmonary disease (COPD), four subjects with respiratory muscle weakness (RMW) with scoliosis, and eight subjects with RMW without scoliosis).RESULTSThe peak cough expiratory flow rate and cough expiratory volume were not improved by manually assisted cough and mechanical insufflation alone or in combination in normal subjects. The median increase in peak cough expiratory flow in subjects with RMW without scoliosis with manually assisted cough alone or in combination with mechanical insufflation of 84 l/min (95% confidence interval (CI) 19 to 122) and 144 l/min (95% CI 14 to 195), respectively, reflects improvement in the expulsive phase of coughing by these techniques. Manually assisted cough and mechanical insufflation in combination raised peak expiratory flow rate more than either technique alone in this group. The abnormal chest shape in scoliotic subjects and the fixed inspiratory pressure used made effective manually assisted cough and mechanical insufflation difficult in this group and no improvements were found. In patients with COPD manually assisted cough alone and in combination with mechanical insufflation decreased peak expiratory flow rate by 144 l/min (95% CI 25 to 259) and 135 l/min (95% CI 30 to 312), respectively.CONCLUSIONSManually assisted cough and mechanical insufflation should be considered to assist expectoration of secretions in patients with RMW without scoliosis but not in those with scoliosis.

scholarly journals Expiration Training Maneuver for Chronic Obstructive Pulmonary Disease with Congestive Heart Failure Grade II: A Case Report

2019 ◽  
Vol 7 (01) ◽  
pp. 28
Author(s):  
Nury Nusdwinuringtyas ◽  
Siti Chandra Widjanantie
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Muscle Strength ◽  
Pulmonary Disease ◽  
Respiratory Muscle ◽  
Walking Distance ◽  
Chronic Obstructive ◽  
Respiratory Muscle Strength ◽  
Obstructive Pulmonary Disease ◽  
Before And After ◽  
Grade Ii

Introduction: Chronic Obstructive Pulmonary Disease (COPD) was characteristic by the inflammatory process in the airway which causes air trapping and hyperinflation, then followed by decreasing the respiratory muscle strength. Breathing training using the positive expiratory pressure (PEP) increasing respiratory muscle strength.Methods: A case presentation of a male, age was 60 years old diagnosed as COPD by The Global Initiative for Chronic Obstructive Lung Disease (GOLD) grade 4 group D, and Chronic Heart Failure (CHF) grade II, with complication of excessive phlegm, underweight, and weakness of respiratory muscle, have PEP for 8 weeks.Results: Spirometry evaluation before and after eight week of PEP have found; FEV1 22.12 and 22.42%, FVC 34.24 and 56%, FEV1/FVC 76.8 and 64%. Respiratory muscle strength before and after PEP showed the Muscle Inspiratory Pressure (MIP) 46 and 71 cmH2O, Muscle Expiratory Pressure (MEP) 48 and 104 cmH2O.The values of Six Minute Walk Test (6MWT) evaluation by BORG modified scale before and after PEP were 11 and 13 ( efforts), 2 and 3 (dyspnea), 0 and 1 (Leg Fatigue). The six-minute walking distance (6MWD) before and after PED were 170 and 190 m, equation reference with Nury’s formula showed percentage prediction before and after PEP respectively 29.2 and 32%, VO2Max; 4.96 and 6L, METs; 1.41 and 1.7. The St GeorgeRespiratory Questionnaire (SGRQ) before and after PEP were 20.6 and 49.5% (symptom), 86.6 and 45.1% (activity), 45.5 and 18.4% (impact) and 53.6 and 42% for total.Conclusion: Positive airway pressure exercise had beneficial effect on reducing air-trapping process in COPD and increasing the respiratory muscle strength for both expiratory and inspiratory muscle strength.Keywords: Chronic obstructive pulmonary disease, positive expiratory pressure device, respiratory muscle strength, six minutes walking distance

Effect of simulated breath sounds on ventilation

1964 ◽  
Vol 19 (2) ◽  
pp. 233-235 ◽  
Author(s):  
M. Henry Williams ◽  
Cecile Kane
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Normal Subjects ◽  
Alveolar Ventilation ◽  
Respiratory Frequency ◽  
Auditory Stimuli ◽  
Chronic Obstructive ◽  
Breathing Rate ◽  
Obstructive Pulmonary Disease ◽  
Breath Sounds

When normal subjects listened to simulated breath sounds while breathing at their natural respiratory frequency there was a significant decrease of alveolar Pco2. The alveolar Pco2 did not fall further when these subjects listened to the simulator and breathed slowly, but when they breathed with the simulator at a very rapid frequency there was further fall of the PaCOCO2. When patients with chronic obstructive pulmonary disease listened to simulated breath sounds while breathing at their natural respiratory frequency there was a decrease of arterial Pco2 which fell further when the subjects breathed with the simulator at a slow respiratory rate. breathing, effect of auditory stimuli on; breathing rate and pulmonary function on chronic obstructive pulmonary disease; alveolar ventilation and auditory respiratory stimuli; respiratory frequency and ventilation Submitted on July 12, 1963

Non-invasive Assessment of Respiratory Muscle Function and its Relationship to Exercise Tolerance in Patients with Chronic Obstructive Pulmonary Disease

2006 ◽  
Vol 34 (3) ◽  
pp. 240-246 ◽  
Author(s):  
J Chlumský ◽  
P Filipova ◽  
M Terl
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Muscle Function ◽  
Exercise Tolerance ◽  
Respiratory Muscle ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Non Invasive ◽  
Respiratory Muscle Function ◽  
Copd Patients

Most patients with chronic obstructive pulmonary disease (COPD) have impaired respiratory muscle function. Maximal oesophageal pressure correlates closely with exercise tolerance and seems to predict the distance walked during the 6-min walk test. This study assessed the non-invasive parameters of respiratory muscle function in 41 patients with COPD to investigate their relationship to pulmonary function tests and exercise tolerance. The COPD patients, who demonstrated the full range of airway obstruction severity, had a mean forced expiratory volume in 1 s of 42.5% predicted (range, 20–79% predicted). Both the maximal inspiratory muscle strength and non-invasive tension-time index were significantly correlated with the degree of lung hyperinflation, as expressed by the ratio of residual volume to total lung capacity, and the distance walked in 6 min. We conclude that respiratory muscle function was influenced mainly by lung hyperinflation and that it had an important effect on exercise tolerance in COPD patients.

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