Effect of manually assisted cough technique on cough strength in extubated patients with organophosphorus poisoning
DOI:
https://doi.org/10.18203/2320-6012.ijrms20233696Keywords:
Organophosphorus poisoning, PCF, MEP, MAC techniquesAbstract
Background: Organophosphate (OP) ingestion is one of the most common emergencies treated at poisoning control centers worldwide. In an extubated patient with OPP, the abdomen and chest muscles are affected, it also affects a person's ability to breathe on their own, rendering them dependent on a ventilator. Intubation weakens the abdominal muscles and diaphragm making it difficult to cough and clear the chest. A manual cough-assisted technique is used to enhance the cough strength, to help with the clearance of secretions it can be carried out in lying, side-lying, or sitting positions. Objectives were to find the effect of a manually assisted cough (MAC) technique on cough strength (Peak cough flow (PCF) and maximum expiratory pressure) in extubated patients with organophosphorus poisoning.
Methods: According to the selection criteria, 50 participants extubated with organophosphorus poisoning were included. A baseline assessment was done of all individuals and MAC techniques were given. outcome measures were assessed with PCF meter and PEmax manometer. MAC techniques are given for 1 week to each patient.
Results: Pre and post-intervention PCF and maximal expiratory pressure (MEP) was compared and analyzed with paired t tests and which shows an extremely significant difference with p<0.0001 which indicates significant improvement in cough strength after 1 week of MAC techniques.
Conclusions: This study concluded that the MAC. Technique improved the cough strength (PCF and MEP) in extubated patients with organophosphorus poisoning.
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References
Lyagin I, Efremenko E. Enzymes, reacting with organophosphorus compounds as detoxifiers: diversity and functions. Int J Molec Sci. 2021;22(4):1761.
Jain M, Yadav P, Joshi A, Kodgire P. Advances in detection of hazardous organophosphorus compounds using organophosphorus hydrolasebased biosensors. Critical Rev Toxicol. 2019;49(5):387-410.
Wenninger S, Stahl K, Wirner C, Einvag K, Thiele S, Walter MC, Schoser B. Utility of maximum inspiratory and expiratory pressures as a screening method for respiratory insufficiency in slowly progressive neuromuscular disorders. Neuromuscular Disorders. 2020;30(8):640-8.
Farkhondeh T, Mehrpour O, Buhrmann C, Pourbagher-Shahri AM, Shakibaei M, Samarghandian S. Organophosphorus compounds and MAPK signaling pathways. Int J Molecul Sci. 2020;21(12):4258.
Parmar K, Gunjal SB. Effectiveness of Manually Assisted Cough Technique on Peak Cough Flow in Patients with Spinal Cord Injury. Int J Res Rev. 2020;7(2):243-8.
Worek F, Thiermann H, Wille T. Organophosphorus compounds and oximes: a critical review. Arch Toxicol. 2020;94(7):2275-92.
Wenninger S, Stahl K, Wirner C, Einvag K, Thiele S, Walter MC et al. Utility of maximum inspiratory and expiratory pressures as a screening method for respiratory insufficiency in slowly progressive neuromuscular disorders. Neuromuscular Disord. 2020;30(8):640-8.
Lacombe M, Boré A, Castrillo LD, Boussaïd G, Falaize L, Vlachos E et al. Peak cough flow fails to detect upper airway collapse during negative pressure titration for cough-assist. Arch Physical Med Rehabil. 2019;100(12):2346-53.
Almeida CM, Lopes AJ, Guimarães FS. Cough peak flow to predict the extubation outcome: comparison between three cough stimulation methods. Canadian J Respirat Therapy. 2020;56:58.
Ahmed S, Martin AD, Smith BK. Inspiratory muscle training in patients with prolonged mechanical ventilation: narrative review. Cardiopulmonary Physical Therapy J. 2019;30(1):44.
Spinou A. A review on cough augmentation techniques: assisted inspiration, assisted expiration and their combination. Physiological Res. 2020;69(1):S93.
Ferreira ND, Ferreira AD, Guimarães FS. Cough peak flow to predict extubation outcome: a systematic review and meta-analysis. Revista Brasileira Terapia Intensiva. 2021;33:445-56.
An SK, Shin WS. Effect of air stacking training on pulmonary function, respiratory strength and peak cough flow in persons with cervical spinal cord injury. Physical Therapy Rehabilitation Sci. 2018;7(4):147-53.
Gobert F, Yonis H, Tapponnier R, Fernandez R, Labaune MA, Burle JF et al. Predicting extubation outcome by cough peak flow measured using a built-in ventilator flow meter. Respiratory Care. 2017;62(12):1505-19.
Combret Y, Prieur G, Hilfiker R, Gravier FE, Smondack P, Contal O et al. The relationship between maximal expiratory pressure values and critical outcomes in mechanically ventilated patients: a post hoc analysis of an observational study. Ann Intensive Care. 2021;11(1):1-8.