Comparison of Mechanical Insufflation-Exsufflation and Endotracheal Suctioning in Mechanically Ventilated Patients: Effects on Respiratory Mechanics, Hemodynamics, and Volume of Secretions.

Indian J Crit Care Med

Methodist University IPA, Course of Physiotherapy Postgraduate Program in Rehabilitation and Inclusion, and Postgraduate Program in Biosciences and Rehabilitation, Porto Alegre, Brazil.

Published: July 2018

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.

Download full-text PDF

Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6069318PMC
http://dx.doi.org/10.4103/ijccm.IJCCM_164_18DOI Listing

Publication Analysis

Top Keywords

mechanical insufflation-exsufflation
12
mechanically ventilated
12
respiratory mechanics
12
endotracheal suctioning
8
suctioning mechanically
8
ventilated patients
8
oxygen saturation
8
blood pressure
8
lung compliance
8
-test compare
8

Similar Publications

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.

View Article and Find Full Text PDF
Article Synopsis
  • Existing Mechanical Insufflation-Exsufflation (MI-E) devices fail to adequately control cough airflow pressure during expiration, risking airway collapse and damage.
  • This study aims to improve cough assist systems by implementing PID and adaptive control methods to better regulate airway pressure.
  • The adaptive control method enhances pressure tracking and peak flow rates for mucus clearance, demonstrating significant clinical safety and therapeutic benefits, particularly for critically ill patients with mucus clearance challenges.
View Article and Find Full Text PDF

Accuracy of Real-Time Data Provided by Mechanical Insufflation-Exsufflation Devices.

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.

View Article and Find Full Text PDF

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 PDF

[Expert recommendations on the clinical application of mechanical insufflation-exsufflation in mechanically ventilated patients (2024)].

Zhonghua 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.

View Article and Find Full Text PDF

Want AI Summaries of new PubMed Abstracts delivered to your In-box?

Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!