<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>0138-6557</journal-id>
<journal-title><![CDATA[Revista Cubana de Medicina Militar]]></journal-title>
<abbrev-journal-title><![CDATA[Rev Cub Med Mil]]></abbrev-journal-title>
<issn>0138-6557</issn>
<publisher>
<publisher-name><![CDATA[Centro Nacional de Información de Ciencias MédicasEditorial Ciencias Médicas]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S0138-65572020000100013</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Presiones y pico flujo tosido en la asistencia mecánica de la tos]]></article-title>
<article-title xml:lang="en"><![CDATA[Pressures used and peak cough flow during mechanical cough assistance]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Herrero]]></surname>
<given-names><![CDATA[Maria Victoria]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
<xref ref-type="aff" rid="Aaf"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Unidad de Internación de Kinesiología Hospital Interzonal General de Agudos &#8220;Petrona Villegas de Cordero&#8221; ]]></institution>
<addr-line><![CDATA[San Fernando ]]></addr-line>
<country>Argentina</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,Servicio de Kinesiología Clínica Zabala Swiss Medical Group]]></institution>
<addr-line><![CDATA[Ciudad Autónoma de Buenos Aires ]]></addr-line>
<country>Argentina</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>03</month>
<year>2020</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>03</month>
<year>2020</year>
</pub-date>
<volume>49</volume>
<numero>1</numero>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://scielo.sld.cu/scielo.php?script=sci_arttext&amp;pid=S0138-65572020000100013&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.sld.cu/scielo.php?script=sci_abstract&amp;pid=S0138-65572020000100013&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.sld.cu/scielo.php?script=sci_pdf&amp;pid=S0138-65572020000100013&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[RESUMEN  Introducción:  En las personas con enfermedad neuromuscular, la incapacidad para toser y para generar flujos espiratorios adecuados constituye el principal limitante para mantener una adecuada salud del sistema respiratorio. La asistencia mecánica de la tos es un dispositivo que genera presión positiva y negativa en la vía aérea y simula una tos normal. Se realizó una revisión bibliográfica. Se incluyeron 9 estudios, con un total de 235 sujetos adultos con enfermedad neuromuscular.  Objetivos:  Describir los valores de presiones de insuflación y exsuflación utilizados y su relación con los valores de pico flujo tosido.  Desarrollo:  El 28 % era de género femenino y las edades estaban comprendidas entre 14 a 77 años. Las presiones utilizadas variaron entre los estudios, con valores que iban desde +15/ -15 cm H2O a los +40/ -40 cm H2O. Con respecto a los valores de pico flujo tosido, 7 estudios observaron incrementos estadísticamente significativos al aplicar la terapéutica. En estos estudios, para obtener un flujo espiratorio superior a 160 L/min se requirieron presiones de al menos -30/+30 cm H2O.  Conclusiones:  Se requieren futuras investigaciones que permitan el desarrollo de un consenso respecto a aplicación de la asistencia mecánica de la tos en sujetos con enfermedad neuromuscular, así como establecer criterios de selección de las presiones de insuflación y exsuflación a programar durante la terapéutica.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[ABSTRACT  Introduction:  In people with neuromuscular disease, the inability to cough and generate adequate expiratory flows is the main limitation to maintain adequate health of the respiratory system. The mechanical assistance of the cough is a device that generates positive and negative pressure in the airway, simulating a normal cough. 9 studies were included, with a total of 235 adult subjects with neuromuscular disease.  Objectives:  Describe the values &#8203;&#8203;of insufflation and exsufflation pressures used and to describe their relationship with peak cough flow values.  Development:  28 % were female and the ages between 14 and 77 years old. The pressures used varied between the different studies, with values &#8203;&#8203;ranging from + 15 / -15 cm H2O to + 40 / -40 cm H2O. According to the peak cough flow values, seven studies observed statistically significant increases when applying the therapy. In these studies, to obtain an expiratory flow greater than 160 L / min, at least -30 / + 30 cm H2O were required.  Conclusions:  Future research is required to allow the development of a consensus regarding the application of mechanical cough assistance in subjects with neuromuscular disease, as well as establishing selection criteria for insufflation and exsufflation pressures to be programmed during therapy.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[enfermedad neuromuscular]]></kwd>
<kwd lng="es"><![CDATA[insuflación]]></kwd>
<kwd lng="es"><![CDATA[exsuflación]]></kwd>
<kwd lng="es"><![CDATA[asistencia de la tos]]></kwd>
<kwd lng="es"><![CDATA[debilidad tusígena]]></kwd>
<kwd lng="es"><![CDATA[cuidados respiratorios]]></kwd>
<kwd lng="en"><![CDATA[Neuromuscular disease]]></kwd>
<kwd lng="en"><![CDATA[in-exsufflator]]></kwd>
<kwd lng="en"><![CDATA[cough assistance]]></kwd>
<kwd lng="en"><![CDATA[cough weakness]]></kwd>
<kwd lng="en"><![CDATA[respiratory care]]></kwd>
</kwd-group>
</article-meta>
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