Changes in peak expiratory flow rates using two head-tilt/chin-lift maneuver angles in young healthy conscious volunteers


Autoři: Sion Jo aff001;  Jae Baek Lee aff001;  Youngho Jin aff001;  Taeoh Jeong aff001;  Jaechol Yoon aff001;  Boyoung Park aff004;  Jin Mu Jung aff005
Působiště autorů: Department of Emergency Medicine, College of Medicine, Chonbuk National University, Jeonju, Jeollabuk-do, Republic of Korea aff001;  Research Institute of Clinical Medicine of Chonbuk National University, Jeonju, Jeollabuk-do, Republic of Korea aff002;  Biomedical Research Institute of Chonbuk National University Hospital, Jeonju, Jeollabuk-do, Republic of Korea aff003;  Department of Medicine, Hanyang University College of Medicine, Seoul, Republic of Korea aff004;  Division of Mechanical Design Engineering, College of Engineering, Chonbuk National University, Jeonju, Jeollabuk-do, Republic of Korea aff005
Vyšlo v časopise: PLoS ONE 14(10)
Kategorie: Research Article
doi: 10.1371/journal.pone.0224155

Souhrn

Background

The head-tilt/chin-lift (HT/CL) maneuver is simple and routinely used to open a closed upper airway.

Objectives

It has yet to be determined whether increasing the HT/CL angle further would be beneficial.

Methods

We enrolled 60 (30 males) 20-year-old conscious participants. Pre-HT/CL, post-HT/CL #1, and post-HT/CL #2 positions were defined as positions in which the angle between the ear–eye line and the horizontal line was 80°, 65°, and 50°, respectively. Peak exploratory flow rates (PEFRs) pre-HT/CL, post-HT/CL #1, and post-HT/CL #2 positions were recorded continuously at 1-minute intervals (one set). Five sets of measurements were performed (total, 15 measurements for each participant).

Results

We analysed 900 measurements (180 sets). The mean PEFRs pre-HT/CL, post-HT/CL #1, and post-HT/CL #2 positions were 348.4 ± 96.9, 366.4 ± 104.9, and 378.8 ± 111.2 L/min (percentage change compared to pre-HT/CL, 5.2% and 8.7%), respectively. Significant differences were observed among pre-HT/CL, post-HT/CL #1, and post-HT/CL #2 positions in all participants, as well as in subgroup classified according to sex, and medians of height, body weight, and body mass index.

Conclusion

Our findings suggest that a greater HT/CL angle would be beneficial, as the PEFR increased gradually. The decreasing manner in the PEFR increase with the HT/CL angle implies the existence of an angle threshold beyond which there were no further benefits in airflow, indicating a minimum in airway resistance. A HT/CL maneuver may be appropriate until locking the atlanto-occipital and cervical spine joints in extension occurs and the chest (sternal notch) begins to rise.

Klíčová slova:

Analysis of variance – Body mass index – Body weight – Eels – Flow rate – Mathematical models – Neck – Chin


Zdroje

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PLOS One


2019 Číslo 10