科研之友
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摘要
objective: to evaluate cough efficiency using two manually-assisted cough techniques. methods: we selected 28 patients with duchenne muscular dystrophy. the patients were receiving noninvasive nocturnal ventilatory support and presented fvc values %26lt; 60% of predicted. peak cough flow (pcf) was measured, with the patient seated, at four time points: at baseline, during a spontaneous maximal expiratory effort (mee); during an mee while receiving chest compression; during an mee after air stacking with a manual resuscitation bag; and during an mee with air stacking and compression (combined technique). the last three measurements were conducted in random order. the results were compared using pearson%26apos;s correlation test and anova with repeated measures, followed by tukey%26apos;s post-hoc test (p %26lt; 0.05). results: the mean age of the patients was 20 ㊣ 4 years, and the mean fvc was 29 ㊣ 12%. mean pcf at baseline, with chest compression, after air stacking and with the use of the combined technique was 171 ㊣ 67, 231 ㊣ 81, 225 ㊣ 80, and 292 ㊣ 86 l/min, respectively. the results obtained with the use of the combined technique were significantly better than were those obtained with the use of either technique alone (f[3.69] = 67.07; p %26lt; 0.001). conclusions: both chest compression and air stacking techniques were efficient in increasing pcf. however, the combination of these two techniques had a significant additional effect (p %26lt; 0.0001).
