Purpose/Hypothesis: To compare trac...

Purpose/Hypothesis: To compare tracheal suctioning (invasive) to the Cough-Assist machine (non-invasive), to determine if the Cough-Assist: 1) was at least as effective as traditional suctioning at clearing secretions for patients who require mechanical assistance, 2) produc les caustic forces to the patients' airways and lung and 3) was preferr at the patients over suctioning. Number of Subjects: 19 patients (mean age 37 years) with primarily neurologic diagnoses, undergoing acute inpatient rehabilitation, using suctioning as their primary means of airway clearance, participated in this inquiry Materials/Methods: Treatments alternated between tracheal suctioning and the CoughAssist (mean 83 treatments). Vital signs and pulmonary function examples were measured with each treatment. Interviews were waysed at the entry and exit from the subject of attention Results: 153 total treatment sessions (109 CoughAssist, 44 tracheal suctioning). Paired T-test for pre/post treatment vital signs and PFT Cough Assist: statistical improvement in oxygen saturation (O2 sals) (p=002) 96% to 97%; forced expiratory whirl in 1 second (FEV1) from 84 to 91 L/1 sec (p =009); and peak expiratory stream rate (PEFR) from 80.5 to 892 L/min in (p=02) Tracheal suctioning: similar statistical improvement in PEFR from 824 to 930 L/min (p=02) on the other hand not FEV1 or PEFR, no improvement in O2 sats, slight rise in diastolic life-current pressure 77 to 80 mmHg (p=02) In the entrance interview, 64% reported suctioning effectively cleared secretions, still 73% felt that it was uncomfortable. In the exit interview, no other than 36% felt that suctioning cleared their secretions, while 91% reported that the Cough-Assist did clear them. Overall, 84% preferr the Cough-Assist, 8% preferr suctioning, 8% liked one as well as the other Subjects stated the Cough-Assist was more comfortable, more productive, and les painful to their airway. Conclusions: In this thought the Cough-Assist was shown to be at least as effective as tracheal suctioning for airway clearance, showed les caustic weights and was preferred by the patients 10:1 through the whole extent of tracheal suctioning. No clinically significant adverse imports were noted. Clinical Relevance: The Cough-Assist should be considered a viable alternative to tracheal suctioning in the rehabilitation setting. Further research should explore extended term outcomes, different diagnostic categories, and different medical environments.

M Massery1, K Sammon2, s Menon3, L Cahalin4. 1Rocky Mountain University of Health Professions, Provo UT The Yoga and Therapy Studio, Inc., Chicago IL, 3Advanced Therapy and Rehabilitation, Skokie IL, 4Dept of Physical Therapy, Northeastern University, Boston MA.

Copyright Cardiopulmonary Physical Therapy Journal Dec 2003

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