Document Detail


Reliable time to estimate subglottal pressure.
MedLine Citation:
PMID:  18207358     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Measuring subglottal pressure (P(s)) with complete interruption can be problematic due to unsteady plateaus in supraglottal pressure data traces during balloon valve interruption. Subjectively determining when the graph plateaus neglect the effects of laryngeal, auditory, and other physical reflexes may alter patient effort and glottal configuration. If the P(s) estimation was made at a consistent time before the onset of reflexes, the recorded pressure would not be dependent on subjective analysis by a clinician, and intrasubject data would be more precise. Previously collected data using the airflow interruption system have shown consistency at approximately 150 milliseconds after balloon valve inflation. To evaluate the validity of estimating P(s) at this point, a theoretical and a physical model were applied. A theoretical ideal gas model of capacitance calculated the time necessary for supraglottal pressure to equilibrate with P(s). Using a mechanical pseudolung which served as a constant pressure source, known subresistor pressures were compared to the pressure measured by the interruption device. Both models confirmed the validity of measuring P(s) consistently at 150 milliseconds into the 500-millisecond interruption. In human trials testing 25 subjects, mean intrasubject standard deviation using this optimal time constant was 0.66+/-0.37cm H(2)O, and 1.11+/-0.48cm H(2)O when performing plateau analysis (P<0.0005). This novel modification to the clinically feasible interruption model for P(s) estimation demonstrates a marked improvement in the reliability of balloon valve interruption while maintaining the validity demonstrated in previous studies.
Authors:
Matthew R Hoffman; Christopher D Baggott; Jack Jiang
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural     Date:  2008-01-22
Journal Detail:
Title:  Journal of voice : official journal of the Voice Foundation     Volume:  23     ISSN:  1873-4588     ISO Abbreviation:  J Voice     Publication Date:  2009 Mar 
Date Detail:
Created Date:  2009-03-09     Completed Date:  2009-07-16     Revised Date:  2014-09-14    
Medline Journal Info:
Nlm Unique ID:  8712262     Medline TA:  J Voice     Country:  United States    
Other Details:
Languages:  eng     Pagination:  169-74     Citation Subset:  IM    
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MeSH Terms
Descriptor/Qualifier:
Glottis / physiology*
Humans
Models, Biological
Pressure
Pulmonary Ventilation
Time Factors
Grant Support
ID/Acronym/Agency:
R01 DC008153/DC/NIDCD NIH HHS; R01 DC008153-01A2/DC/NIDCD NIH HHS; R01DC008153/DC/NIDCD NIH HHS
Comments/Corrections

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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