The effect of a mechanical glottis on peak expiratory flow rate and time to peak flow during a peak expiratory flow manoeuvre: A study in normal subjects and patients with motor neurone disease

• Published in: Anaesthesia Vol. 59; no. 9; pp. 872 - 875
• Main Authors: Suleman, M., Abaza, K. T., Gornall, C., Kinnear, W. J. M., Wills, J. S., Mahajan, R. P.
• Format: Journal Article
• Language: English
• Published: Oxford, UK Blackwell Science Ltd 01.09.2004; Blackwell
• Subjects: Adult; Aged; Anesthesia; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Biological and medical sciences; Bulbar Palsy, Progressive - physiopathology; Bulbar Palsy, Progressive - rehabilitation; Cough; Cough - physiopathology; Glottis; Glottis - physiopathology; Humans; Insufflation - instrumentation; Medical sciences; Middle Aged; Motor Neuron Disease - physiopathology; Motor Neuron Disease - rehabilitation; Peak Expiratory Flow Rate; Respiratory Muscles - physiopathology; Respiratory Therapy - instrumentation; Human; Nervous system diseases; Peak expiratory flow rate; Central nervous system disease; Motor neuron disease; Cough. Glottis; Anesthesia; Degenerative disease; Expiratory flow rate; Glottis; Spinal cord disease; Cough
• ISSN: 0003-2409; 1365-2044
• DOI: 10.1111/j.1365-2044.2004.03779.x

Summary We have evaluated a mechanical glottis in healthy volunteers and in patients with bulbar motor neurone disease. In healthy volunteers, the mechanical glottis increased peak flow rate and decreased the time to peak flow during forced expiration, but cough produced even higher flow rates and shorter times to peak flow. In patients, the mechanical glottis increased peak flow rate and decreased the time to peak flow. The mechanical glottis also produced higher peak flow rates when compared to the cough manoeuvres, and the time to peak flow was also significantly shorter with the mechanical glottis. We have shown that the use of a mechanical glottis tends to convert the airflow profile of a peak expiratory flow manoeuvre into that of a cough in both healthy volunteers and patients with motor neurone disease. Its potential role as an aid to clearance of airway secretions in patients with impaired laryngeal function remains to be seen.