Performance of the CoughAssist Insufflation-Exsufflation Device in the Presence of an Endotracheal Tube or Tracheostomy Tube: A Bench Study
The CoughAssist is a mechanical insufflator-exsufflator designed to assist airway secretion clearance in patients with ineffective cough. The device may benefit intubated and tracheotomized patients. We assessed the impact of various artificial airways on peak expiratory flow (PEF) with the CoughAss...
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| Veröffentlicht in: | Respiratory care 2011-08, Vol.56 (8), p.1108-1114 |
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| creator | GUERIN, Claude BOURDIN, Gael LERAY, Véronique DELANNOY, Bertrand BAYLE, Frédérique GERMAIN, Michele RICHARD, Jean-Christophe |
| description | The CoughAssist is a mechanical insufflator-exsufflator designed to assist airway secretion clearance in patients with ineffective cough. The device may benefit intubated and tracheotomized patients. We assessed the impact of various artificial airways on peak expiratory flow (PEF) with the CoughAssist.
We measured PEF and pressure at the airway opening in a lung model during insufflation-exsufflation with the CoughAssist, at 3 set pressures: 30/-30, 40/-40, and 50/-50 cm H(2)O, first without (control), and then with different sizes (6.5 to 8.5 mm inner diameter) of endotracheal tube (ETT) and tracheostomy tube (6, 7, and 8 mm inner diameter), compliance settings of 30 and 60 mL/cm H(2)O, and resistance settings of 0 and 5 cm H(2)O/L/s). We analyzed the relationship between PEF and pressure with linear regression.
With compliance of 30 mL/cm H(2)O and 0 resistance the slope of the control relationship between PEF and pressure was statistically significantly greater than during any conditions with ETT or tracheostomy tube. Therefore, in comparison to the control, the relationship of PEF to pressure significantly went in the direction from top to bottom as the ETT or tracheostomy tube became narrower. The findings were the same with compliance of 30 mL/cm H(2)O and resistance of 5 cm H(2)O/L/s. With compliance of 60 mL/cm H(2)O the highest set pressure values were not achieved and some relationships departed from linearity. The control slope of the relationship between PEF and pressure with compliance of 60 mL/cm H(2)O and 0 resistance did not significantly differ with any ETT or tracheostomy tube.
The artificial airways significantly reduced PEF during insufflation-exsufflation with CoughAssist; the narrower the inner diameter of the artificial airway, the lower the PEF for a given expiratory pressure. |
| doi_str_mv | 10.4187/respcare.01121 |
| format | Article |
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We measured PEF and pressure at the airway opening in a lung model during insufflation-exsufflation with the CoughAssist, at 3 set pressures: 30/-30, 40/-40, and 50/-50 cm H(2)O, first without (control), and then with different sizes (6.5 to 8.5 mm inner diameter) of endotracheal tube (ETT) and tracheostomy tube (6, 7, and 8 mm inner diameter), compliance settings of 30 and 60 mL/cm H(2)O, and resistance settings of 0 and 5 cm H(2)O/L/s). We analyzed the relationship between PEF and pressure with linear regression.
With compliance of 30 mL/cm H(2)O and 0 resistance the slope of the control relationship between PEF and pressure was statistically significantly greater than during any conditions with ETT or tracheostomy tube. Therefore, in comparison to the control, the relationship of PEF to pressure significantly went in the direction from top to bottom as the ETT or tracheostomy tube became narrower. The findings were the same with compliance of 30 mL/cm H(2)O and resistance of 5 cm H(2)O/L/s. With compliance of 60 mL/cm H(2)O the highest set pressure values were not achieved and some relationships departed from linearity. The control slope of the relationship between PEF and pressure with compliance of 60 mL/cm H(2)O and 0 resistance did not significantly differ with any ETT or tracheostomy tube.
The artificial airways significantly reduced PEF during insufflation-exsufflation with CoughAssist; the narrower the inner diameter of the artificial airway, the lower the PEF for a given expiratory pressure.</description><identifier>ISSN: 0020-1324</identifier><identifier>EISSN: 1943-3654</identifier><identifier>DOI: 10.4187/respcare.01121</identifier><identifier>PMID: 21801577</identifier><identifier>CODEN: RECACP</identifier><language>eng</language><publisher>Irving, TX: Daedalus</publisher><subject>Airway obstruction (Medicine) ; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy ; Artificial respiration ; Biological and medical sciences ; Care and treatment ; Cough ; Cough - physiopathology ; Cough - therapy ; Critical care medicine ; Emergency and intensive care: metabolism and nutrition disorders. Enteral and parenteral nutrition ; Equipment Design ; Exhalation ; Forced Expiratory Flow Rates - physiology ; Humans ; Insufflation - instrumentation ; Intensive care medicine ; Intubation, Intratracheal - instrumentation ; Medical equipment ; Medical sciences ; Methods ; Physical Therapy Modalities - instrumentation ; Physiological apparatus ; Practice ; Respiration, Artificial - instrumentation ; Respiratory Insufficiency - physiopathology ; Respiratory Insufficiency - therapy ; Tracheostomy - instrumentation</subject><ispartof>Respiratory care, 2011-08, Vol.56 (8), p.1108-1114</ispartof><rights>2015 INIST-CNRS</rights><rights>COPYRIGHT 2011 Daedalus Enterprises, Inc.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3771-234b9c9d8c64b43e53e2a9882931cd86cf9ba7fbcb57f3d179c8eb4503a33b943</citedby><cites>FETCH-LOGICAL-c3771-234b9c9d8c64b43e53e2a9882931cd86cf9ba7fbcb57f3d179c8eb4503a33b943</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27901,27902</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=24426145$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/21801577$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>GUERIN, Claude</creatorcontrib><creatorcontrib>BOURDIN, Gael</creatorcontrib><creatorcontrib>LERAY, Véronique</creatorcontrib><creatorcontrib>DELANNOY, Bertrand</creatorcontrib><creatorcontrib>BAYLE, Frédérique</creatorcontrib><creatorcontrib>GERMAIN, Michele</creatorcontrib><creatorcontrib>RICHARD, Jean-Christophe</creatorcontrib><title>Performance of the CoughAssist Insufflation-Exsufflation Device in the Presence of an Endotracheal Tube or Tracheostomy Tube: A Bench Study</title><title>Respiratory care</title><addtitle>Respir Care</addtitle><description>The CoughAssist is a mechanical insufflator-exsufflator designed to assist airway secretion clearance in patients with ineffective cough. The device may benefit intubated and tracheotomized patients. We assessed the impact of various artificial airways on peak expiratory flow (PEF) with the CoughAssist.
We measured PEF and pressure at the airway opening in a lung model during insufflation-exsufflation with the CoughAssist, at 3 set pressures: 30/-30, 40/-40, and 50/-50 cm H(2)O, first without (control), and then with different sizes (6.5 to 8.5 mm inner diameter) of endotracheal tube (ETT) and tracheostomy tube (6, 7, and 8 mm inner diameter), compliance settings of 30 and 60 mL/cm H(2)O, and resistance settings of 0 and 5 cm H(2)O/L/s). We analyzed the relationship between PEF and pressure with linear regression.
With compliance of 30 mL/cm H(2)O and 0 resistance the slope of the control relationship between PEF and pressure was statistically significantly greater than during any conditions with ETT or tracheostomy tube. Therefore, in comparison to the control, the relationship of PEF to pressure significantly went in the direction from top to bottom as the ETT or tracheostomy tube became narrower. The findings were the same with compliance of 30 mL/cm H(2)O and resistance of 5 cm H(2)O/L/s. With compliance of 60 mL/cm H(2)O the highest set pressure values were not achieved and some relationships departed from linearity. The control slope of the relationship between PEF and pressure with compliance of 60 mL/cm H(2)O and 0 resistance did not significantly differ with any ETT or tracheostomy tube.
The artificial airways significantly reduced PEF during insufflation-exsufflation with CoughAssist; the narrower the inner diameter of the artificial airway, the lower the PEF for a given expiratory pressure.</description><subject>Airway obstruction (Medicine)</subject><subject>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy</subject><subject>Artificial respiration</subject><subject>Biological and medical sciences</subject><subject>Care and treatment</subject><subject>Cough</subject><subject>Cough - physiopathology</subject><subject>Cough - therapy</subject><subject>Critical care medicine</subject><subject>Emergency and intensive care: metabolism and nutrition disorders. Enteral and parenteral nutrition</subject><subject>Equipment Design</subject><subject>Exhalation</subject><subject>Forced Expiratory Flow Rates - physiology</subject><subject>Humans</subject><subject>Insufflation - instrumentation</subject><subject>Intensive care medicine</subject><subject>Intubation, Intratracheal - instrumentation</subject><subject>Medical equipment</subject><subject>Medical sciences</subject><subject>Methods</subject><subject>Physical Therapy Modalities - instrumentation</subject><subject>Physiological apparatus</subject><subject>Practice</subject><subject>Respiration, Artificial - instrumentation</subject><subject>Respiratory Insufficiency - physiopathology</subject><subject>Respiratory Insufficiency - therapy</subject><subject>Tracheostomy - instrumentation</subject><issn>0020-1324</issn><issn>1943-3654</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2011</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNptkU1v1DAQhi1ERZfClSOyhIBTlvgjsc1tWbYfUiUqsZwjxxk3Rkm82AlifwN_Gm-6pSBVPljz6nlHM_Mi9IrkS06k-BAg7owOsMwJoeQJWhDFWcbKgj9FizyneUYY5afoeYzfU1nyQj1Dp5TInBRCLNDvGwjWh14PBrC3eGwBr_10265idHHEV0OcrO306PyQbX49FPgz_HTJ44bZc5MGgWMPPeDN0PgxaNOC7vB2qpMe8HYWfBx9v5_Fj3iFPyVXi7-OU7N_gU6s7iK8PP5n6Nv5Zru-zK6_XFytV9eZYUKQjDJeK6MaaUpecwYFA6qVlFQxYhpZGqtqLWxt6kJY1hChjISaFznTjNXpPGfo_V3fXfA_Johj1btooOv0AH6KlZS5IEoqmcg3d-St7qByg52XOtDVipZUSCEJS9TyESq9Bnpn_ADWJf0_w7t_DIcbjW303XS4a3y0swk-xgC22gXX67CvSF4d8q_u86_m_JPh9XG1qe6h-YvfB56At0dAR6M7G1LwLj5wnNOS8IL9AfQ1uVU</recordid><startdate>201108</startdate><enddate>201108</enddate><creator>GUERIN, Claude</creator><creator>BOURDIN, Gael</creator><creator>LERAY, Véronique</creator><creator>DELANNOY, Bertrand</creator><creator>BAYLE, Frédérique</creator><creator>GERMAIN, Michele</creator><creator>RICHARD, Jean-Christophe</creator><general>Daedalus</general><general>Daedalus Enterprises, Inc</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>201108</creationdate><title>Performance of the CoughAssist Insufflation-Exsufflation Device in the Presence of an Endotracheal Tube or Tracheostomy Tube: A Bench Study</title><author>GUERIN, Claude ; BOURDIN, Gael ; LERAY, Véronique ; DELANNOY, Bertrand ; BAYLE, Frédérique ; GERMAIN, Michele ; RICHARD, Jean-Christophe</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3771-234b9c9d8c64b43e53e2a9882931cd86cf9ba7fbcb57f3d179c8eb4503a33b943</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2011</creationdate><topic>Airway obstruction (Medicine)</topic><topic>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy</topic><topic>Artificial respiration</topic><topic>Biological and medical sciences</topic><topic>Care and treatment</topic><topic>Cough</topic><topic>Cough - physiopathology</topic><topic>Cough - therapy</topic><topic>Critical care medicine</topic><topic>Emergency and intensive care: metabolism and nutrition disorders. Enteral and parenteral nutrition</topic><topic>Equipment Design</topic><topic>Exhalation</topic><topic>Forced Expiratory Flow Rates - physiology</topic><topic>Humans</topic><topic>Insufflation - instrumentation</topic><topic>Intensive care medicine</topic><topic>Intubation, Intratracheal - instrumentation</topic><topic>Medical equipment</topic><topic>Medical sciences</topic><topic>Methods</topic><topic>Physical Therapy Modalities - instrumentation</topic><topic>Physiological apparatus</topic><topic>Practice</topic><topic>Respiration, Artificial - instrumentation</topic><topic>Respiratory Insufficiency - physiopathology</topic><topic>Respiratory Insufficiency - therapy</topic><topic>Tracheostomy - instrumentation</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>GUERIN, Claude</creatorcontrib><creatorcontrib>BOURDIN, Gael</creatorcontrib><creatorcontrib>LERAY, Véronique</creatorcontrib><creatorcontrib>DELANNOY, Bertrand</creatorcontrib><creatorcontrib>BAYLE, Frédérique</creatorcontrib><creatorcontrib>GERMAIN, Michele</creatorcontrib><creatorcontrib>RICHARD, Jean-Christophe</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Respiratory care</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>GUERIN, Claude</au><au>BOURDIN, Gael</au><au>LERAY, Véronique</au><au>DELANNOY, Bertrand</au><au>BAYLE, Frédérique</au><au>GERMAIN, Michele</au><au>RICHARD, Jean-Christophe</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Performance of the CoughAssist Insufflation-Exsufflation Device in the Presence of an Endotracheal Tube or Tracheostomy Tube: A Bench Study</atitle><jtitle>Respiratory care</jtitle><addtitle>Respir Care</addtitle><date>2011-08</date><risdate>2011</risdate><volume>56</volume><issue>8</issue><spage>1108</spage><epage>1114</epage><pages>1108-1114</pages><issn>0020-1324</issn><eissn>1943-3654</eissn><coden>RECACP</coden><abstract>The CoughAssist is a mechanical insufflator-exsufflator designed to assist airway secretion clearance in patients with ineffective cough. The device may benefit intubated and tracheotomized patients. We assessed the impact of various artificial airways on peak expiratory flow (PEF) with the CoughAssist.
We measured PEF and pressure at the airway opening in a lung model during insufflation-exsufflation with the CoughAssist, at 3 set pressures: 30/-30, 40/-40, and 50/-50 cm H(2)O, first without (control), and then with different sizes (6.5 to 8.5 mm inner diameter) of endotracheal tube (ETT) and tracheostomy tube (6, 7, and 8 mm inner diameter), compliance settings of 30 and 60 mL/cm H(2)O, and resistance settings of 0 and 5 cm H(2)O/L/s). We analyzed the relationship between PEF and pressure with linear regression.
With compliance of 30 mL/cm H(2)O and 0 resistance the slope of the control relationship between PEF and pressure was statistically significantly greater than during any conditions with ETT or tracheostomy tube. Therefore, in comparison to the control, the relationship of PEF to pressure significantly went in the direction from top to bottom as the ETT or tracheostomy tube became narrower. The findings were the same with compliance of 30 mL/cm H(2)O and resistance of 5 cm H(2)O/L/s. With compliance of 60 mL/cm H(2)O the highest set pressure values were not achieved and some relationships departed from linearity. The control slope of the relationship between PEF and pressure with compliance of 60 mL/cm H(2)O and 0 resistance did not significantly differ with any ETT or tracheostomy tube.
The artificial airways significantly reduced PEF during insufflation-exsufflation with CoughAssist; the narrower the inner diameter of the artificial airway, the lower the PEF for a given expiratory pressure.</abstract><cop>Irving, TX</cop><pub>Daedalus</pub><pmid>21801577</pmid><doi>10.4187/respcare.01121</doi><tpages>7</tpages><oa>free_for_read</oa></addata></record> |
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| source | MEDLINE; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; PubMed Central |
| subjects | Airway obstruction (Medicine) Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy Artificial respiration Biological and medical sciences Care and treatment Cough Cough - physiopathology Cough - therapy Critical care medicine Emergency and intensive care: metabolism and nutrition disorders. Enteral and parenteral nutrition Equipment Design Exhalation Forced Expiratory Flow Rates - physiology Humans Insufflation - instrumentation Intensive care medicine Intubation, Intratracheal - instrumentation Medical equipment Medical sciences Methods Physical Therapy Modalities - instrumentation Physiological apparatus Practice Respiration, Artificial - instrumentation Respiratory Insufficiency - physiopathology Respiratory Insufficiency - therapy Tracheostomy - instrumentation |
| title | Performance of the CoughAssist Insufflation-Exsufflation Device in the Presence of an Endotracheal Tube or Tracheostomy Tube: A Bench Study |
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