Article

OBJECTIVE: To assess cough using air stacking (AS)
to assist inspiratory volume with abdominal compression (AC) during expiration in
patients with American Spinal Injury Association Impairment Scale (AIS)
A.Setting:Large tertiary hospital in Chile. METHODS: Peak cough flow (PCF) was
measured during four different interventions: spontaneous maximal expiratory
effort (MEE); MEE while receiving AC (MEE-AC); MEE after AS with a manual
resuscitation bag (AS-MEE); and MEE with AS and AC (AS-MEE-AC). RESULTS: Fifteen
in-patients with complete tetraplegia (C4-C6) were included. Median age was 33
years (16-56). PCF during the different interventions was PCF for MEE was
183+/-90 l min(-1); PCF for MEE-AC was 273+/-119 l min(-1); PCF for AS-MEE was
278+/-106 l min(-1) and PCF for AS-MEE-AC was 368+/-129 l min(-1). We observed
significant differences in PCF while applying MEE-AC and AS-MEE compared with MEE
(P=0.0001). However, the difference in PCF value was greater using the AS-MEE-AC
technique (P=0.00001). CONCLUSION: Patients with spinal cord injury (SCI)
presented an ineffective cough that constitutes a risk factor for developing
respiratory complications. The application of combined techniques (AS-MEE-AC) can
reach near normal PCF values. This is a low-cost, simple and easily applied
intervention that could be introduced to all patients with tetraplegia.

Langue : ANGLAIS