MECHANICS OF COUGH IN NORMAL SUBJECTS AND IN PATIENTS WITH OBSTRUCTIVE RESPIRATORY DISEASE

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Abstract
Eso-phageal pressures, air flow rates, and expired volume were measured during a series of coughs and forced expirations in 9 healthy subjects and in 9 patients with severe chronic obstructive respiratory disease. The large area screen pneumotachygraph and other equipment used were calibrated using methods and equipment specially devised to ensure accurate measurement of the sudden large changes in pressure and air flow rates involved. Replication showed a high degree of reproducibility in the measurements made. Peak pressure, peak air flow rate, resistance at peak flow, and resistance at peak pressure during cough and during forced expiration were compared. Peak flow preceded peak pressure in every case. Among healthy subjects resistance at peak pressure tended to be higher during forced expiration than during cough; among the patients, the reverse was true. Most of the patients narrowed their airways to an increased extent during cough; this led to tussive inefficiency that may present a great a hazard to them as does their ventilatory inefficiency.

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