Cough augmentation in amyotrophic lateral sclerosis.
Cough flows and pressures were measured during cough augmentation in healthy subjects and patients with bulbar and nonbulbar amyotrophic lateral sclerosis. Manual assistance increased flow 11% in bulbar (p < 0.01) and 13% in nonbulbar (p < 0.001) patients. Mechanical insufflation-exsufflation increased flow 17% in healthy subjects (p < 0.05), 26% (p < 0.001) in bulbar, and 28% (p < 0.001) in nonbulbar patients. The greatest improvements were in patients with the weakest coughs. Patient group and level of weakness influenced the effect of augmentation.
Mustfa
N
N
Respiratory Muscle Laboratory, Guy's, King's and St. Thomas' School of Medicine, King's College Hospital, London, UK. naveed@doctors.org.uk
Aiello
M
M
Lyall
R A
RA
Nikoletou
D
D
Olivieri
D
D
Leigh
P N
PN
Davidson
A C
AC
Polkey
M I
MI
Moxham
J
J
D000690:Amyotrophic Lateral Sclerosis / Q000150:complications / Q000503:physiopathology*; D003371:Cough / Q000503:physiopathology*; D045853:Exhalation; D005260:Female; D006801:Humans; D001239:Inhalation; D008297:Male; D010366:Peak Expiratory Flow Rate / Q000502:physiology; D012016:Reference Values; D012018:Reflex / Q000502:physiology; D012121:Respiration, Artificial / Q000295:instrumentation / Q000379:methods*; D012131:Respiratory Insufficiency / Q000209:etiology / Q000628:therapy*; D016896:Treatment Outcome; D015919:Ventilators, Negative-Pressure