title: [Assisted cough--physiotherapy to improve expectoration of mucus].
abstract: Pulmonary complications are the most common causes of mortality in patients with severe inspiratory and/or expiratory muscle weakness. An inspiratory tidal volume below 1500 ml and a peak cough flow below 160 L/min result in mucus retention and increase the risk of pneumonia. An intact cough function is pivotal for airway clearance during acute and chronic airway infections with increased mucus production as well as for protection against endotracheal aspirations. Effective cough requires that all of its phases work or are effectively supported. Non-invasive assistance of inspiration can be provided by manual hyperinflation, air stacking, glossopharyngeal breathing or mechanical insufflation. Safe and effective methods of expiration assistance include manual thorax and abdominal compression, manual self-assistance as well as mechanical insufflation-exsufflation. The use of these non-invasive inspiratory and expiratory muscle aids can decrease the risk of pulmonary complications in patients with severe ventilatory muscle weakness.
authors.affiliation: Interne Lungenabteilung, Respiratory Care Unit, Otto-Wagner-Spital, Wien. ingrid.schmidt@wienkav.at
authors.forename: I
authors.initials: I
authors.lastname: Schmidt
mesh_terms: D003371:Cough / Q000534:rehabilitation*; D006801:Humans; D009093:Mucus / Q000378:metabolism*; D026741:Physical Therapy Modalities; D012120:Respiration Disorders / Q000534:rehabilitation*; D012138:Respiratory Therapy / Q000379:methods*