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Numerical Analysis of Airway Mucus Clearance Effectiveness Using Assisted Coughing Techniques.

ABSTRACT: Cough is a protective respiratory reflex used to clear respiratory airway mucus. For patients with cough weakness, such as chronic obstructive pulmonary disease, neuromuscular weakness disease and other respiratory diseases, assisted coughing techniques are essential to help them clear mucus. In this study, the Eulerian wall film model was applied to simulate the coughing clearance process through a computational fluid dynamics methodology. Airway generation 0 to generation 2 based on realistic geometry is considered in this study. To quantify cough effectiveness, cough efficiency was calculated. Moreover, simulations of four different coughing techniques applied for chronic obstructive pulmonary disease and neuromuscular weakness disease were conducted. The influences of mucus film thickness and mucus viscosity on cough efficiency were analyzed. From the simulation results, we found that with increasing mucus film thickness and decreasing mucus viscosity, cough efficiency improved accordingly. Assisted coughing technologies have little influence on the mucus clearance of chronic obstructive pulmonary disease models. Finally, it was observed that the cough efficiency of the mechanical insufflation-exsufflation technique (MIE) is more than 40 times the value of an unassisted coughing technique, which indicates that the MIE technology has a great effect on airway mucus clearance for neuromuscular weakness disease models.

SUBMITTER: Ren S

PROVIDER: S-EPMC7005022 | biostudies-literature | 2020 Feb

REPOSITORIES: biostudies-literature

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Numerical Analysis of Airway Mucus Clearance Effectiveness Using Assisted Coughing Techniques.

Ren Shuai S Li Wei W Wang Lin L Shi Yan Y Cai Maolin M Hao Liming L Luo Zihao Z Niu Jinglong J Xu Weiqing W Luo Zujin Z

Scientific reports 20200206 1

Cough is a protective respiratory reflex used to clear respiratory airway mucus. For patients with cough weakness, such as chronic obstructive pulmonary disease, neuromuscular weakness disease and other respiratory diseases, assisted coughing techniques are essential to help them clear mucus. In this study, the Eulerian wall film model was applied to simulate the coughing clearance process through a computational fluid dynamics methodology. Airway generation 0 to generation 2 based on realistic ...[more]

PMID: 32029825

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Project description:BackgroundIn patients with bronchiectasis, airway clearance techniques (ACTs) are important management strategies.Research questionWhat are the differences in patients with bronchiectasis and a productive cough who used ACTs and those who did not? What was the assessment of bronchiectasis exacerbation frequency and change in pulmonary function at 1-year follow up?Study design and methodsAdult patients with bronchiectasis and a productive cough in the United States Bronchiectasis and NTM Research Registry were included in the analyses. ACTs included the use of instrumental devices and manual techniques. Stratified analyses of demographic and clinical characteristics were performed by use of ACTs at baseline and follow up. The association between ACT use and clinical outcomes was assessed with the use of unadjusted and adjusted multinomial logistic regression models.ResultsOf the overall study population (n = 905), 59% used ACTs at baseline. A greater proportion of patients who used ACTs at baseline and follow up continuously had Pseudomonas aeruginosa (47% vs 36%; P = .021) and experienced an exacerbation (81% vs 59%; P < .0001) or hospitalization for pulmonary illness (32% vs 22%; P = .001) in the prior two years, compared with those patients who did not use ACTs. Fifty-eight percent of patients who used ACTs at baseline did not use ACTs at 1-year follow up. There was no significant change in pulmonary function for those who used ACTs at follow up, compared with baseline. Patients who used ACTs at baseline and follow up had greater odds for experiencing exacerbations at follow up compared with those patients who did not use ACTs.InterpretationIn patients with bronchiectasis and a productive cough, ACTs are used more often if the patients have experienced a prior exacerbation, hospitalization for pulmonary illness, or had P aeruginosa. There is a significant reduction in the use of ACTs at 1-year follow up. The odds of the development of a bronchiectasis exacerbation are higher in those patients who use ACTs continuously, which suggests more frequent use in an ill bronchiectasis population.

Dataset Information

Numerical Analysis of Airway Mucus Clearance Effectiveness Using Assisted Coughing Techniques.

Publications

Numerical Analysis of Airway Mucus Clearance Effectiveness Using Assisted Coughing Techniques.

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