Cough Augmentation in Subjects With XXXX : Comparison of Air Stacking via a Resuscitator Bag Versus Mechanical Ventilation.

@entity1 @entity1555 @entity4094 @entity425
BACKGROUND: Air stacking improves cough effectiveness in @entity1 with @entity1555 ( @entity1555 ) and @entity425 . However, it is not known whether air stacking is more effective via a resuscitator bag or a home ventilator. METHODS: This prospective randomized study investigated the effect of air stacking via a volume-cycled home ventilator versus via a resuscitator bag in @entity1 with @entity1555 . Maximum insufflation capacity and peak expiratory flow during spontaneous (cough peak flow) and air stacking-assisted cough maneuvers (air stacking-assisted cough peak flow) were measured. RESULTS: Fifty-two adult @entity1555 subjects receiving noninvasive ventilation were included in the study: 27 @entity1 performed air stacking via their home ventilator (home-ventilator group; age = 25.3    5.1 y; forced vital capacity (FVC) = 809    555 mL), and 25 @entity1 used a resuscitator bag (resuscitator-bag group; age = 24.7    5.7 y, FVC = 807    495 mL). Following a single training session, air stacking could be performed successfully by 89% (home ventilator) and 88% (resuscitator bag) of @entity1 . There were comparable maximum insufflation capacities (1,481 mL for the home-ventilator group vs 1,344 mL for the resuscitator-bag group, P = .33) and mean air stacking-assisted cough peak flow values (199 L/min for the home-ventilator group vs 186 L/min for the resuscitator-bag group, P = .33) between techniques. Air stacking-assisted cough peak flow increased significantly compared with baseline in both groups (mean increase: +51% [home ventilator] vs +49% [resuscitator bag], P < .001), with individual air stacking-assisted cough peak flow improvements ranging from -20 to 245%. CONCLUSIONS: Cough augmentation is an important component of the respiratory management of @entity1 with a @entity4094 . No difference in cough effectiveness as measured by air stacking-assisted cough peak flow was found in air stacking via a ventilator compared with via a resuscitator bag. Both methods achieved mean air stacking-assisted cough peak flow values of >160 L/min. Provision of an inexpensive resuscitator bag can effectively improve cough capacity, and it is simple to use, which may improve access to respiratory care in @entity1 with @entity1555 .
