Artificial external glottic device for passive lung insufflation.
OBJECTIVE
For patients with neuromuscular disease, air stacking, which inflates the lungs to deep volumes, is important for many reasons. However, neuromuscular patients with severe glottic dysfunction or indwelling tracheostomy tubes cannot air stack effectively. For these patients, we developed a device that permits deep lung insufflations substituting for glottic function.


METHODS
Thirty- seven patients with bulbar-innervated muscle weakness and/or tracheostomies were recruited. Twenty-three had amyotrophic lateral sclerosis, and 14 were tetraplegic patients due to cervical spinal cord injury. An artificial external glottic device (AEGD) was used to permit passive deep lung insufflation. In order to confirm the utility of AEGD, vital capacity, maximum insufflation capacity (MIC), and lung insufflation capacity (LIC) with AEGD (LICA) were measured.


RESULTS
For 30 patients, MICs were initially zero. However, with the use of the AEGD, LICA was measurable for all patients. The mean LICA was 1,622.7±526.8 mL. Although MIC was measurable for the remaining 7 patients without utilizing the AEGD, it was significantly less than LICA, which was 1,084.3±259.9 mL and 1,862.9±248 mL, respectively (p<0.05).


CONCLUSIONS
The AEGD permits lung insufflation by providing deeper lung volumes than possible by air stacking.
Department of Rehabilitation Medicine and Rehabilitation, Yonsei University College of Medicine, Seoul, Korea.
Dong Hyun
DH
Kim
Seong-Woong
SW
Kang
Yoon Ghil
YG
Park
Won Ah
WA
Choi
Hye Ree
HR
Lee
D000328:Adult; D000368:Aged; D005260:Female; D005540:Forced Expiratory Flow Rates / Q000502:physiology; D006801:Humans; D007327:Insufflation / Q000295:instrumentation* / Q000379:methods; D008297:Male; D008875:Middle Aged; D009468:Neuromuscular Diseases / Q000503:physiopathology* / Q000628:therapy; D012122:Ventilators, Mechanical; D014797:Vital Capacity / Q000502:physiology; D055815:Young Adult