Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2020 May 26:5:20200011.
doi: 10.2490/prm.20200011. eCollection 2020.

Lung Insufflation Capacity with a New Device in Amyotrophic Lateral Sclerosis: Measurement of the Lung Volume Recruitment in Respiratory Therapy

Keisuke Yorimoto  1 , Yosuke Ariake  1 , Takako Saotome  1 , Madoka Mori-Yoshimura  2 , Tadashi Tsukamoto  2 , Yuji Takahashi  2 , Yoko Kobayashi  1
Affiliations

Lung Insufflation Capacity with a New Device in Amyotrophic Lateral Sclerosis: Measurement of the Lung Volume Recruitment in Respiratory Therapy

Keisuke Yorimoto et al. Prog Rehabil Med. .

Abstract

Objective: The aim of this study was to validate the usefulness of the measurement of lung insufflation capacity (LIC) using the LIC TRAINER (LT) in patients with amyotrophic lateral sclerosis (ALS).

Methods: This retrospective study was conducted in the rehabilitation departments of the Japanese National Center of Neurology and Psychiatry and involved 20 ALS patients who underwent respiratory therapy between April 1, 2014, and December 2017. The vital capacity (VC), maximum insufflation capacity (MIC), and LIC measurements at the start of respiratory therapy were extracted from the medical records, and patients were divided into three groups: group A, VC could not be measured; group B, VC could be measured, but MIC was less than VC; and group C, MIC was larger than VC. LIC could be measured in all groups. In group C, paired t-tests were used to analyze whether there was a significant difference in the volumes measured using different methods.

Results: LIC was 950, 1863±595, and 2980±1176 ml in groups A (n=1), B (n=10), and C (n=9), respectively. In groups A and B, LIC could be measured in all patients, even when VC or MIC could not be measured. In group C, the measured LIC value was significantly greater than MIC (p=0.003).

Conclusion: LIC could be successfully measured using the LT. By using the LT, it was feasible to conveniently perform LIC measurements, suggesting that it could be a useful device for performing respiratory therapy in ALS patients.

Keywords: amyotrophic lateral sclerosis; lung insufflation capacity; lung volume recruitment; new device; respiratory therapy.

PubMed Disclaimer

Conflict of interest statement

CONFLICTS OF INTEREST: The LT was co-developed by our hospital and Cater Technologies (Saitama, Japan). The authors state that they have no other conflicts of interest.

Figures

Fig. 1.
Fig. 1.
The LIC TRAINER (LT) (components from Cater Technologies, Japan). (A) The LT comprises a one-way valve, a safety valve, and an expiration relief valve. (B) LT setup: the BVM is attached to the primary port (IN) of the LT. The mask is attached to the secondary port (OUT) of the LT. (C) Operation of the LT: the patient’s nose and mouth are covered by the mask. The patient holds the expiration relief valve in their hand. The assistant slowly applies pressure several times with the BVM. The patient inhales as much as they can tolerate, before releasing their thumb from the expiration relief valve and exhaling deeply.
Fig. 2.
Fig. 2.
Measurement of VC, MIC, and LIC in the present study. Patients were divided into three groups: group A, VC could not be measured; group B, VC could be measured, but MIC was less than VC; and group C, MIC was larger than VC. LIC could be measured in all members of all groups. In group C, LIC was significantly greater than MIC (t=–4.257, p=0.003).
See this image and copyright information in PMC

References

    1. Haverkamp LJ,Appel V,Appel SH: Natural history of amyotrophic lateral sclerosis in a database population. Validation of a scoring system and a model for survival prediction. Brain 1995;118:707–719. 10.1093/brain/118.3.707 - DOI - PubMed
    1. Chatwin M,Toussaint M,Gonçalves MR,Sheers N,Mellies U,Gonzales-Bermejo J,Sancho J,Fauroux B,Andersen T,Hov B,Nygren-Bonnier M,Lacombe M,Pernet K,Kampelmacher M,Devaux C,Kinnett K,Sheehan D,Rao F,Villanova M,Berlowitz D,Morrow BM: Airway clearance techniques in neuromuscular disorders: a state of the art review. Respir Med 2018;136:98–110. 10.1016/j.rmed.2018.01.012 - DOI - PubMed
    1. Finder JD,Birnkrant D,Carl J,Farber HJ,Gozal D,Iannaccone ST,Kovesi T,Kravitz RM,Panitch H,Schramm C,Schroth M,Sharma G,Sievers L,Silvestri JM,Sterni L, American Thoracic Society: Respiratory care of the patient with Duchenne muscular dystrophy: ATS consensus statement. Am J Respir Crit Care Med 2004;170:456–465. 10.1164/rccm.200307-885ST - DOI - PubMed
    1. Bach JR,Mahajan K,Lipa B,Saporito L,Goncalves M,Komaroff E: Lung insufflation capacity in neuromuscular disease. Am J Phys Med Rehabil 2008;87:720–725. 10.1097/PHM.0b013e31817fb26f - DOI - PubMed
    1. Kim DH,Kang SW,Park YG,Choi WA,Lee HR: Artificial external glottic device for passive lung insufflation. Yonsei Med J 2011;52:972–976. 10.3349/ymj.2011.52.6.972 - DOI - PMC - PubMed