China
Africa
Explore chapters and articles related to this topic
Neurology in Documentaries
Published in Eelco F. M. Wijdicks, Neurocinema—The Sequel, 2022
It is not known how many patients are still in an iron lung—the number may approach 50 in the United States. Many patients also use the so-called glossopharyngeal breathing—“frog” breathing. The technique was developed during the poliomyelitis epidemic. Patients used muscles of the mouth and pharynx to push air into the lower airways. Glossopharyngeal breathing is an emergency backup for patients with a malfunctioning iron lung, and this method can sustain ventilation for several hours.
Neuromuscular disorders
Published in Claudio F. Donner, Nicolino Ambrosino, Roger S. Goldstein, Pulmonary Rehabilitation, 2020
Miguel R. Gonçalves, John R. Bach
Evaluation necessitates four items: a spirometer, peak flow metre, capnograph, and oximeter. The VC is measured in sitting and supine positions and the difference should be less than 7%. Since hypoventilation is worse during sleep, the supine VC is the more important. When supine VC is much lower than when sitting, sleep NVS is warranted. Spirometry is also useful for monitoring progress with GPB and air stacking, that is, retention of a maximum lung volume of air attained by the consecutive delivery of boluses of air via a manual resuscitator or volume-cycling ventilator that is held by the glottis. The maximum volume is termed the maximum insufflation capacity (MIC). Patients who learn GPB can often achieve a glossopharyngeal breathing maximum single breathe capacity as great as the MIC, and at times greater (3). A nasal interface or lipseal can also be used for air stacking when the lips are too weak for effective air stacking via the mouth (Figure 37.1).
Neurologic Disorders in Documentary Film
Published in Eelco F.M. Wijdicks, Neurocinema, 2014
It is not known how many patients are still in an iron lung—the number it may approach 50 in the United States. Many patients would also use the so-called glossopharyngeal breathing—“frog” breathing. The technique was developed during the poliomyelitis epidemic. Patients used muscles of the mouth and pharynx to push air into the lower airways. Glossopharyngeal breathing has been an emergency method for patients confined to the iron lung, and this method could sustain ventilation for several hours.
Section 5: Airway clearance
Published in Canadian Journal of Respiratory, Critical Care, and Sleep Medicine, 2018
Searches were conducted looking for publications on (1) glossopharyngeal breathing, lung volume recruitment and airway clearance in respiratory muscle weakness and/or neuromuscular disease; (2) physiotherapy techniques (including positive end expiratory pressure, percussion, active cycle of breathing, high frequency chest wall oscillation and intra-pulmonary percussive ventilation in individuals with respiratory muscle weakness and/or neuromuscular disease; and (3) airway clearance in tracheostmomized individuals. We aimed at identifying all studies published in English and French. We searched Cochrane and MEDLINE databases (1966–August 24, 2015). As well, we hand-searched reference lists from identified publications in order to add any missed studies. We also searched the web sites of large associations of physicians and health professionals in the field of respiratory medicine, intensive care, nursing and respiratory therapy for reviews, consensus statements and clinical practice guidelines. We obtained the full publication of all relevant studies identified
Acute effects of glossopharyngeal insufflation in people with cervical spinal cord injury
Published in The Journal of Spinal Cord Medicine, 2018
Malin Nygren-Bonnier, Tomas A. Schiffer, Peter Lindholm
GI is a technique that is performed by using the muscles of the mouth, cheeks, lips, tongue, soft palate, larynx, and pharynx to piston boluses of air into the lungs. In glossopharyngeal breathing, the patients first perform a TLC maneuver and then beyond that, they perform cycles of as many gulps of air as possible, followed by the relaxing of the larynx and passive expulsion of the air.6,15,16 All measurements were performed by two test leaders. Measurements were performed before, during, and after performing cycles of maximal GI first in a sitting position, and thereafter before and during maximal cycles of GI in a supine position. The participants first carried out a maximal inhalation, then performed GI using as many gulps of air as possible without the onset of discomfort.15 Immediately following GI, the participants opened their airways while relaxing the thorax, against a small mouthpiece from which mouth airway pressure (Paw) was obtained. A moment later, the pressure was released and the participant exhaled to RV in order to measure the VC. At the end of the expiration, a valve was opened to an anaesthetic bag pre-filled with 3 litres of pure dry oxygen, which the participants re-breathed until nitrogen was equilibrated. This allowed their RV to be determined by the nitrogen dilution method (inert gas was calculated as 1-(FO2+FCO2), corrected for H2O). All participants performed GI through the mouth. Lung function, MAP, Paw, and HR were measured simultaneously while performing GI. Each participant performed the procedure three times, in a sitting position at baseline, in a sitting position with GI, in a supine position with GI, and finally in a sitting position after the intervention. The best of three values were used in the analysis.
Successful decannulation of patients with traumatic spinal cord injury: A scoping review
Published in The Journal of Spinal Cord Medicine, 2022
Gordon H. Sun, Stephanie W. Chen, Mark P. MacEachern, Jing Wang
NIVS is the provision of mechanical ventilation without resorting to endotracheal intubation or tracheostomy. Non-invasive body ventilators have been used to treat prolonged respiratory failure since the 1830s.23 Early mechanisms for non-invasive ventilator support in patients with SCI and other neurological disorders included the intermittent abdominal pressure ventilator and the “rocking bed,” which directly produce diaphragmatic movement, and negative-pressure ventilators such as the famous “iron lung,” which generate air movement via the creation of sub-atmospheric pressure over the chest wall and abdomen.23 The newest class of non-invasive ventilatory devices intermittently generates positive pressure via oral, nasal, or oral/nasal interfaces such as mouthpieces, face masks, and nasal prongs. Publications on the effectiveness of these tools appeared as early as 197150 but with increasing frequency in the early 1990s.22,26 These devices are used in conjunction with mechanically-assisted coughing (MAC), as well as manual techniques delivered by caregivers, to mobilize and eliminate pulmonary secretions that can contribute to hypoxia, pneumonia, and other adverse sequelae. Mechanical insufflation-exsufflation (MIE) devices are a common modality for MAC and a key component of various studies on decannulation or extubation of otherwise “unweanable” SCI patients.28,29,37,43,46 Further patient-generated, non-invasive ventilatory support can be provided by glossopharyngeal breathing (GPB), or more colloquially “frog breathing,” a technique utilizing oral and pharyngeal muscles to propel boluses of air into the lungs and using the larynx to trap the air there until needed.51 Although it can be used to provide backup ventilation for hours in the event of catastrophic equipment failure, GPB has poor effectiveness in patients with existing tracheostomies due to air leakage out of the stoma and can be perceived as a difficult technique to master.23,52 Bach has published indications for decannulation of ventilator-dependent patients to NIVS in several papers.25,27,28 Bach’s team27 also reported that the primary contraindications to the use of NIVS in patients with SCI and other neuromuscular disorders are uncontrollable seizure disorder or other conditions causing inability to cooperate.