Effects of Mechanical Insufflation-Exsufflation on Airway Mucus Clearance Among Mechanically Ventilated ICU Subjects

Abstract

Among the general ICU subjects receiving mechanical ventilation, use of an MI-E device during respiratory physiotherapy resulted in a larger amount of airway mucus clearance than respiratory physiotherapy alone. (ClinicalTrials.gov registration NCT03178565.).

Mechanical Insufflation-Exsufflation Is Safe in Mechanically Ventilated Patients

“…We thank Guimarães and Rocha for their interest and comments regarding our study, 1 as well as the suggestions and doubts they advance. We have a few comments regarding their concerns.…”

Physical Therapy and Rehabilitation in Chronic Obstructive Pulmonary Disease Patients Admitted to the Intensive Care Unit

“…Patients undergoing MI-E presented significant lower reintubation rates (17 vs. 48%; p < 0.05), and decreased time on mechanical ventilation (17.8 AE 6.4 vs. 11.7 AE 3.5 days; p < 0.05) and ICU length of stay after extubation (3.1 AE 2.5 vs. 9.8 AE 6.7 days; p < 0.05). A randomized parallel group trial 74 MI-E pressures of þ40/À 40 cm H 2 O are commonly set to achieve comfortable and effective treatments in patients with unaffected lung mechanics. However, higher inspiratory-expiratory pressures may be necessary in patients with pathologies entailing an increase in respiratory resistances and/or decreased compliance (e.g., COPD).…”

Mechanical Insufflation-Exsufflation: Room for Improvement

“…Mechanical insufflation-exsufflation is a technique used to facilitate the clearance of airway secretions in patients with a weak cough. It can be performed in the hospital setting, including patients who are critically ill 1,2 or at home in patients with chronic neuromuscular weakness. 3 With this technique, a specific device first insufflates the respiratory system to a set pressure and then actively withdraws gas to a set negative pressure.…”