Article

OBJECTIVE: To investigate the clinical usefulness and significance of an external
control device substituting for glottic function in determining the feasibility
of decannulation in tracheostomized patients with neuromuscular diseases and
cervical spinal cord injuries whose assisted peak cough flow (APCF) was
unmeasurable or <160L/min. DESIGN: Before-after trial. SETTING: Inpatient setting
in a university hospital. PARTICIPANTS: Tracheostomized patients
(N=16; 11 with
neuromuscular diseases and 5 with cervical spinal cord injuries) were recruited.
INTERVENTIONS: Unassisted peak cough flow (UPCF) and APCF were measured with and
without an external glottic control device. Among patients whose APCF without the
device was <160L/min, if their APCF with the device was measured as >/=160L/min,
they were decannulated. After decannulation, UPCF and APCF were measured again.
MAIN OUTCOME MEASURES: APCF with and without an external glottic control device
as well as APCF after decannulation. RESULTS: After successful decannulation,
APCFs were greater than or equal to those measured with the device before
decannulation. No patients underwent intubation or retracheostomy, and there were
no respiratory complications. CONCLUSIONS: The external glottic control device
substituting for innate glottic function is beneficial for determining
tracheostomy decannulation. It provides an objective and accurate APCF. It is
particularly helpful for patients whose APCF is >/=160L/min while using the
device, even if APCF is <160L/min without this device.
CI - Copyright (c) 2016 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS