TY - JOUR
T1 - Changes in peak expiratory flow rates using two head-tilt/chin-lift maneuver angles in young healthy conscious volunteers
AU - Jo, Sion
AU - Lee, Jae Baek
AU - Jin, Youngho
AU - Jeong, Taeoh
AU - Yoon, Jaechol
AU - Park, Boyoung
AU - Jung, Jin Mu
N1 - Publisher Copyright:
© 2019 Jo et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
PY - 2019/10/1
Y1 - 2019/10/1
N2 - 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.
AB - 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.
UR - https://www.scopus.com/pages/publications/85073616908
U2 - 10.1371/journal.pone.0224155
DO - 10.1371/journal.pone.0224155
M3 - Journal article
C2 - 31626679
AN - SCOPUS:85073616908
SN - 1932-6203
VL - 14
JO - PLoS ONE
JF - PLoS ONE
IS - 10
M1 - e0224155
ER -