Context: Cough assist (CA) is a device to improve bronchial hygiene of patients with secretion in the airways and ineffective cough.
Aims: To compare the physiological effects and the volume of secretion of mechanical insufflation-exsufflation (CA device) with isolated endotracheal suctioning in mechanically ventilated patients.
Settings And Design: Randomized crossover trial.
Materials And Methods: The patients were randomly allocated to the first technique, then the following technique was performed in the next day. We collected the variables related to oxygen saturation, hemodynamics (heart rate, systolic blood pressure, diastolic blood pressure, and mean arterial pressure [MAP]), and respiratory mechanics (tidal volume, minute volume, respiratory rate, and lung compliance and resistance), pre- and postimplementation (immediately and after 15 and 30 min), and the aspirated volume of secretion.
Statistical Analysis Used: We used two-way analysis of variance followed by the Student-Newman-Keuls -test to compare the variables at different time points. Student's -test was used to compare secretion volumes. All data were stored and analyzed in SPSS for Windows Version 19.0. The significance level was set at 5%.
Results: Forty-three patients were included in the study. When we compared the results before and after the application of the techniques, we observed no significant difference in lung compliance, pulmonary resistance, MAP, peripheral oxygen saturation, and secretion volume in both groups.
Conclusions: The mechanical insufflation-exsufflation does not alter respiratory mechanics and hemodynamic stability, and it does not improve airway clearance in mechanically ventilated patients.
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http://dx.doi.org/10.4103/ijccm.IJCCM_164_18 | DOI Listing |
Med Intensiva (Engl Ed)
January 2025
Pulmonary and Critical Care Division, University Hospital of Federal University of Juiz de Fora, Brazil; School of Medicine, Federal University of Juiz de Fora, Minas Gerais, Brazil. Electronic address:
Objective: To evaluate the feasibility of adding mechanical insufflation-exsufflation (MI-E) to a weaning protocol for tracheostomized patients undergoing prolonged mechanical ventilation (MV).
Design: Single-center, open-label, randomized, controlled pilot and feasibility study.
Setting: Intensive care unit in Brazil.
Front Bioeng Biotechnol
October 2024
Institute of Stomatology, First Medical Center, Chinese PLA General Hospital, Beijing, China.
Respir Care
October 2024
Drs Martinez-Alejos, Fresnel, and Lebret are affiliated with the Kernel Biomedical. Rouen, France.
Background: Mechanical insufflation-exsufflation (MI-E) is crucial to assist patients with impaired cough, especially those with neuromuscular diseases. Despite recent advancements that enable real-time display of peak expiratory flow (PEF) and inspiratory volume, accurately monitoring these parameters with MI-E devices during treatment can still present challenges.
Methods: A bench study that used a mechanical lung connected to 3 MI-E devices (EOVE-70; E-70 and Comfort Cough II) was conducted to evaluate PEF and inspiratory volume monitoring accuracy.
Muscle Nerve
November 2024
Respiratory and Neurological Institutes, Cleveland Clinic, Cleveland, Ohio, USA.
Dyspnea is a common symptom in neuromuscular disorders and, although multifactorial, it is usually due to respiratory muscle involvement, associated musculoskeletal changes such as scoliosis or, in certain neuromuscular conditions, cardiomyopathy. Clinical history can elicit symptoms such as orthopnea, trepopnea, sleep disruption, dysphagia, weak cough, and difficulty with secretion clearance. The examination is essential to assist with the diagnosis of an underlying neurologic disorder and determine whether dyspnea is from a cardiac or pulmonary origin.
View Article and Find Full Text PDFZhonghua Wei Zhong Bing Ji Jiu Yi Xue
August 2024
Corresponding author: Wang Yuefu, Department of Surgical Critical Care Medicine, Emergency and Critical Care Medical Center, Beijing Shijitan Hospital, Capital Medical University, Beijing, 100038, Email: Zhu Fengxue, Department of Critical Care Medicine, Peking University People's Hospital, Beijing, 100044, Email: Zhou Jianxin, Chinese Society of Critical Care Medicine, Beijing, 100038, Email:
Mechanical ventilated patients are a high-risk group with impaired cough ability and require corresponding medical techniques for cough assistance to clear airway secretions. Mechanical insufflation-exsufflation (MI-E) technology is widely used in patients with cough weakness caused by neuromuscular diseases. However, there is currently a lack of standardized application procedures for mechanically ventilated patients who retain artificial airways, which can affect treatment outcomes.
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