• Respiratory care · Apr 2017

    Air Stacking: A Detailed Look Into Physiological Acute Effects on Cough Peak Flow and Chest Wall Volumes of Healthy Subjects.

    • Antonio Sarmento, Armèle F Dornelas de Andrade, Íllia Nadinne Df Lima, Andrea Aliverti, Guilherme Augusto de Freitas Fregonezi, and Vanessa R Resqueti.
    • PneumoCardioVascular Lab, Hospital Universitário Onofre Lopes, Empresa Brasileira de Serviços Hospitalares (EBSERH), Universidade Federal do Rio Grande do Norte (UFRN), Natal RN, Brazil and the Laboratório de Desempenho PneumoCardioVascular & Músculos Respiratórios, Departamento de Fisioterapia, Universidade Federal do Rio Grande do Norte, UFRN, Natal RN, Brazil.
    • Respir Care. 2017 Apr 1; 62 (4): 432-443.

    BackgroundAir stacking (AS) is a lung insufflation method that requires the use of a manual insufflator to provide air volumes higher than inspiratory capacity. Neuromuscular patients benefit the most from the maneuver; however, the acute effects of AS in healthy subjects are still unclear.MethodsTwenty healthy subjects (8 males) were studied by optoelectronic plethysmography to investigate the immediate effects of AS on cough peak flow, operational volume variations, distribution of these volumes in the chest wall compartments (pulmonary rib cage, abdominal rib cage, and abdominal), breathing pattern, and shortening velocity of the respiratory muscles during a protocol that included vital capacity maneuvers and spontaneous coughs before and after AS.ResultsStatistically significant increases in cough peak flow (P < .03) and inspiratory capacity (P < .001) were found immediately after AS. During its application, the pulmonary rib cage compartment was the largest contributor (P = .002) to chest wall volume displacement. A significant increase in chest wall tidal volume (P < .001), mainly in the pulmonary rib cage (P < .001), was observed. Significant increases (P < .001) in end-inspiratory chest wall volume were observed with main distribution in pulmonary (P < .001) and abdominal rib cage (P = .01). Significant increases in shortening velocity index of inspiratory muscles (P < .001), expiratory muscles (P < .001), and diaphragm (P < .001) were also observed. In addition, significant decreases in expiratory time (P < .001) and increases in duty cycle (P = .02), breathing frequency (P = .02), minute ventilation (P < .001), maximum inspiratory (P < .001), and expiratory flow (P < .001) were observed.ConclusionsIn healthy subjects, cough peak flow and chest wall volumes can be increased immediately after the application of the AS maneuver.Copyright © 2017 by Daedalus Enterprises.

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