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Mechanical in- exsufflation

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https://www.readbyqxmd.com/read/27624630/cough-augmentation-techniques-in-the-critically-ill-a-canadian-national-survey
#1
Louise Rose, Neill K Adhikari, Joseph Poon, David Leasa, Douglas A McKim
BACKGROUND: Critically ill mechanically ventilated patients experience impaired airway clearance due to ineffective cough and impaired secretion mobilization. Cough augmentation techniques, including mechanical insufflation-exsufflation (MI-E), manually assisted cough, and lung volume recruitment, improve cough efficiency. Our objective was to describe use, indications, contraindications, interfaces, settings, complications, and barriers to use across Canada. METHODS: An e-mail survey was sent to nominated local survey champions in eligible Canadian units (ICUs, weaning centers, and intermediate care units) with 4 telephone/e-mail reminders...
October 2016: Respiratory Care
https://www.readbyqxmd.com/read/27593879/a-comparison-of-cough-assistance-techniques-in-patients-with-respiratory-muscle-weakness
#2
Sun Mi Kim, Won Ah Choi, Yu Hui Won, Seong Woong Kang
PURPOSE: To assess the ability of a mechanical in-exsufflator (MI-E), either alone or in combination with manual thrust, to augment cough in patients with neuromuscular disease (NMD) and respiratory muscle dysfunction. MATERIALS AND METHODS: For this randomized crossover single-center controlled trial, patients with noninvasive ventilator-dependent NMD were recruited. The primary outcome was peak cough flow (PCF), which was measured in each patient after a cough that was unassisted, manually assisted following a maximum insufflation capacity (MIC) maneuver, assisted by MI-E, or assisted by manual thrust plus MI-E...
November 2016: Yonsei Medical Journal
https://www.readbyqxmd.com/read/27507303/benefits-of-interventions-for-respiratory-secretion-management-in-adult-palliative-care-patients-a-systematic-review
#3
Juliano Ferreira Arcuri, Ebun Abarshi, Nancy J Preston, Jenny Brine, Valéria Amorim Pires Di Lorenzo
BACKGROUND: Respiratory secretions impact negatively on palliative patients. Unfortunately, a gold standard therapy is not yet available. The purpose of this study was to identify which interventions are in use to control respiratory secretions in patients with chronic disease with a poor prognosis and verify their effects on outcomes relevant for palliative care patients. METHODS: A systematic review of the literature with narrative summary was conducted. We searched eight electronic databases in April (6th), 2016...
2016: BMC Palliative Care
https://www.readbyqxmd.com/read/27507176/respiratory-care-received-by-individuals-with-duchenne-muscular-dystrophy-from-2000-to-2011
#4
Jennifer G Andrews, Aida Soim, Shree Pandya, Christina P Westfield, Emma Ciafaloni, Deborah J Fox, David J Birnkrant, Christopher M Cunniff, Daniel W Sheehan
BACKGROUND: Duchenne muscular dystrophy (DMD) causes progressive respiratory muscle weakness and decline in function, which can go undetected without monitoring. DMD respiratory care guidelines recommend scheduled respiratory assessments and use of respiratory assist devices. To determine the extent of adherence to these guidelines, we evaluated respiratory assessments and interventions among males with DMD in the Muscular Dystrophy Surveillance, Tracking, and Research Network (MD STARnet) from 2000 to 2011...
October 2016: Respiratory Care
https://www.readbyqxmd.com/read/27266899/-review-of-reimbursement-for-instrumental-techniques-used-for-assisted-coughing-and-thoracic-expansion-a-french-national-health-authority-assessment-has
#5
C Auger, E Schapiro, H Galmiche, C Denis
INTRODUCTION: In France, children with neuromuscular diseases and patients with traumatic spinal cord injuries receive reimbursement for home use of intermittent positive-pressure breathing and mechanical in-exsufflators devices. The aim of the study was to update the indications for reimbursement for these both devices. METHODS: A literature review was conducted with several bibliographic databases using the main keywords: intermittent positive-pressure breathing, mechanical insufflation, mechanically-assisted cough, airway clearance...
June 3, 2016: Revue des Maladies Respiratoires
https://www.readbyqxmd.com/read/27190224/effect-of-high-frequency-oscillations-on-cough-peak-flows-generated-by-mechanical-in-exsufflation-in-medically-stable-subjects-with-amyotrophic-lateral-sclerosis
#6
Jesús Sancho, Enric Bures, Saray de La Asunción, Emilio Servera
BACKGROUND: Mechanically assisted coughing with mechanical in-exsufflation (MI-E) is recommended for noninvasive management of respiratory secretions in amyotrophic lateral sclerosis (ALS). To improve the effectiveness of the technique, a new device combining MI-E with high-frequency oscillations (HFO) has been developed. This work aimed to assess the effect of HFO on the cough peak flow generated by MI-E in medically stable subjects with ALS. METHODS: This was a prospective study that included subjects with ALS in a medically stable condition...
August 2016: Respiratory Care
https://www.readbyqxmd.com/read/27174631/laryngeal-response-patterns-influence-the-efficacy-of-mechanical-assisted-cough-in-amyotrophic-lateral-sclerosis
#7
Tiina Andersen, Astrid Sandnes, Anne Kristine Brekka, Magnus Hilland, Hege Clemm, Ove Fondenes, Ole-Bjørn Tysnes, John-Helge Heimdal, Thomas Halvorsen, Maria Vollsæter, Ola Drange Røksund
BACKGROUND: Most patients with amyotrophic lateral sclerosis (ALS) are treated with mechanical insufflation-exsufflation (MI-E) in order to improve cough. This method often fails in ALS with bulbar involvement, allegedly due to upper-airway malfunction. We have studied this phenomenon in detail with laryngoscopy to unravel information that could lead to better treatment. METHODS: We conducted a cross-sectional study of 20 patients with ALS and 20 healthy age-matched and sex-matched volunteers...
May 12, 2016: Thorax
https://www.readbyqxmd.com/read/27118611/quantitation-of-oxygen-induced-hypercapnia-in-respiratory-pump-failure
#8
M Chiou, J R Bach, L R Saporito, O Albert
PURPOSE: To determine the likelihood that clinicians know carbon dioxide levels before administering supplemental oxygen to patients with neuromuscular disorders, to quantitate the effect of oxygen therapy on carbon dioxide retention, and to explore hypercapnia contributing to the need to intubate and use of continuous noninvasive ventilatory support to avert it. BASIC PROCEDURES: A retrospective chart review for patients with neuromuscular disorders intubated or having intubation averted by using continuous noninvasive ventilatory support with carbon dioxide known pre- and during oxygen administration...
September 2016: Revista Portuguesa de Pneumologia
https://www.readbyqxmd.com/read/26837640/uninformed-guidelines-for-mechanical-in-exsufflation
#9
LETTER
María V Herrero, J R Bach
No abstract text is available yet for this article.
2016: Amyotrophic Lateral Sclerosis and Frontotemporal Degeneration
https://www.readbyqxmd.com/read/26689243/abdominal-functional-electrical-stimulation-to-enhance-mechanical-insufflation-exsufflation
#10
Euan J McCaughey, Alan N McLean, David B Allan, Henrik Gollee
CONTEXT: Respiratory complications, attributed to the build-up of secretions in the airway, are a leading cause of rehospitalisation for the tetraplegic population. Previously, we observed that the application of Abdominal Functional Electrical Stimulation (AFES) improved cough function and increased demand for secretion removal, suggesting AFES may aid secretion clearance. Clinically, secretion clearance is commonly achieved by using Mechanical insufflation-exsufflation (MI-E) to simulate a cough...
December 21, 2015: Journal of Spinal Cord Medicine
https://www.readbyqxmd.com/read/26363734/respiratory-management-of-patients-with-fukuyama-congenital-muscular-dystrophy
#11
Takatoshi Sato, Terumi Murakami, Kumiko Ishiguro, Minobu Shichiji, Kayoko Saito, Makiko Osawa, Satoru Nagata, Keiko Ishigaki
BACKGROUND: Fukuyama congenital muscular dystrophy (FCMD), characterized by intellectual impairment associated with cortical migration defects, is an autosomal recessive disorder caused by mutation in the fukutin gene. It is the second most common type of muscular dystrophy in Japan. Respiratory dysfunction, along with cardiomyopathy, can be life-threatening in patients with advanced-stage FCMD. However, few reports have focused on this issue. METHODS: We retrospectively studied respiratory dysfunction and therapeutic management in 48 genetically diagnosed FCMD patients (mean age 11...
March 2016: Brain & Development
https://www.readbyqxmd.com/read/26209016/strategies-for-weaning-from-mechanical-ventilation-a-state-of-the-art-review
#12
REVIEW
Louise Rose
Identification and adoption of strategies to promote timely and successful weaning from mechanical ventilation remain a research and quality improvement priority. The most important steps in the weaning process to prevent unnecessary prolongation of mechanical ventilation are timely recognition of both readiness to wean and readiness to extubate. Strategies shown to be effective in promoting timely weaning include weaning protocols and use of spontaneous breathing trials. This review explores various other strategies that also may promote timely and successful weaning including bundling of spontaneous breathing trials with sedation and delirium monitoring/management as well as early mobility, the use of automated weaning systems and modes that improve patient-ventilator interaction, mechanical insufflation-exsufflation as a weaning adjunct, early extubation to non-invasive ventilation and high flow humidified oxygen...
August 2015: Intensive & Critical Care Nursing: the Official Journal of the British Association of Critical Care Nurses
https://www.readbyqxmd.com/read/26140500/a-preliminary-randomized-trial-of-the-mechanical-insufflator-exsufflator-versus-breath-stacking-technique-in-patients-with-amyotrophic-lateral-sclerosis
#13
RANDOMIZED CONTROLLED TRIAL
Muhammad K Rafiq, Michael Bradburn, Alison R Proctor, Catherine G Billings, Stephen Bianchi, Christopher J McDermott, Pamela J Shaw
A major problem faced by patients with amyotrophic lateral sclerosis (ALS) in respiratory failure is the inability to cough effectively. Forty eligible ALS patients were randomized to the breath-stacking technique using a lung volume recruitment bag (n = 21) or mechanical insufflator-exsufflator MI-E (n = 19) and followed up at three-monthly intervals for at least 12 months or until death. Results showed that there were 13 episodes of chest infection in the breath-stacking group and 19 episodes in the MI-E group (p = 0...
2015: Amyotrophic Lateral Sclerosis and Frontotemporal Degeneration
https://www.readbyqxmd.com/read/26089736/mechanical-insufflation-exsufflation-practice-patterns-among-respiratory-therapists-in-ontario
#14
Shelley Prevost, Dina Brooks, Phillip T Bwititi
BACKGROUND: The mechanical insufflator-exsufflator (MIE) is effective in assisting cough and in helping to avoid unplanned hospitalizations, tracheostomy and long-term ventilation in patients with neuromuscular disease or spinal cord injury. Despite this, the availability and usage of the device in Canada is unknown. OBJECTIVE: To investigate practice patterns and availability of the MIE in Ontario hospitals. METHODS: A cross-sectional, self-administered mail survey was sent to a random sample of 400 respiratory therapists practicing in 96 Ontario hospitals...
2015: Canadian Journal of Respiratory Therapy: CJRT
https://www.readbyqxmd.com/read/25994909/-use-of-pulmonary-rehabilitation-in-the-treatment-of-decreased-respiratory-muscle-strength
#15
Kateřina Neumannová
Decreased respiratory muscle strength could lead to other health problems, which can decrease the quality of life of those patients. Ineffective expectoration and dyspnoea during physical activities and during activity of daily living are the most frequent disorders associated with decreased respiratory muscle strength. Multidisciplinary treatment including pulmonary rehabilitation programme is very important for those patients. Ventilatory muscle training (strength and endurance type of training), airway clearance techniques - active (e...
2015: Casopís Lékar̆ů C̆eských
https://www.readbyqxmd.com/read/25944939/bench-comparative-assessment-of-mechanically-assisted-cough-devices
#16
COMPARATIVE STUDY
Pamela Frigerio, Federico Longhini, Maurizio Sommariva, Enrica G Stagni, Francesco Curto, Tiziana Redaelli, Marco Ciboldi, Anita K Simonds, Paolo Navalesi
BACKGROUND: Mechanically assisted cough devices are used in patients with impaired cough to avoid secretion accumulation. We compared 5 mechanically assisted cough devices by bench testing using a breathing simulator and assessed their user-friendliness. METHODS: We measured inspiratory and expiratory airway pressures and peak expiratory flow, the strongest indicator of cough efficacy. We performed 2 bench tests: 1) to ascertain the differences between preset and actual settings in 3 different machines of each mechanically assisted cough device and 2) to assess the effects of varying respiratory impedance and air leaks on performance of the devices...
July 2015: Respiratory Care
https://www.readbyqxmd.com/read/25943355/use-of-mechanical-airway-clearance-devices-in-the-home-by-people-with-neuromuscular-disorders-effects-on-health-service-use-and-lifestyle-benefits
#17
Trinity Mahede, Geoff Davis, April Rutkay, Sarah Baxendale, Wenxing Sun, Hugh J S Dawkins, Caron Molster, Caroline E Graham
BACKGROUND: People with neuromuscular disorders (NMD) exhibit weak coughs and are susceptible to recurrent chest infections and acute respiratory complications, the most frequent reasons for their unplanned hospital admissions. Mechanical insufflation-exsufflation (MI-E) devices are a non-invasive method of increasing peak cough flow, improving cough efficacy, the clearance of secretion and overcoming atelectasis. There is limited published evidence on the impact of home use MI-E devices on health service utilisation...
2015: Orphanet Journal of Rare Diseases
https://www.readbyqxmd.com/read/25841044/efficacy-of-mechanical-insufflation-exsufflation-in-extubating-unweanable-subjects-with-restrictive-pulmonary-disorders
#18
EDITORIAL
Douglas McKim, Louise Rose
No abstract text is available yet for this article.
April 2015: Respiratory Care
https://www.readbyqxmd.com/read/25516994/lifestyle-implications-of-home-mechanical-insufflation-exsufflation-for-children-with-neuromuscular-disease-and-their-families
#19
Fiona C Moran, Alicia J Spittle, Clare Delany
BACKGROUND: Mechanical insufflation-exsufflation (MI-E) is increasingly used in the home management of children with neuromuscular disease. Research to date has focused on the effect of MI-E on physical health. The aim of this study was to qualitatively investigate the impact of home MI-E on the child and family's lifestyle. METHODS: Eight parents and 3 children participated in semistructured interviews. RESULTS: Five themes emerged from parent interviews demonstrating: (1) lifestyle implications, (2) parents becoming experts, (3) parents developing a sense of control over their child's condition, (4) an element of extra care, and (5) impacts on the parent-child relationship...
July 2015: Respiratory Care
https://www.readbyqxmd.com/read/25492956/efficacy-of-mechanical-insufflation-exsufflation-in-extubating-unweanable-subjects-with-restrictive-pulmonary-disorders
#20
John R Bach, Diane M Sinquee, Louis R Saporito, Amanda L Botticello
BACKGROUND: Subjects who do not pass ventilator weaning parameters but whose ambient air oxyhemoglobin saturation can be normalized by mechanical insufflation-exsufflation (MIE) can be extubated to continuous noninvasive ventilatory support (CNVS) with MIE used to maintain extubation. Our aim was to study MIE-associated changes in breathing tolerance, pulse oximetry, and vital capacity (VC) for consecutive unweanable subjects. METHODS: A retrospective chart review was performed for consecutively referred intubated subjects with single-organ (respiratory muscle) failure...
April 2015: Respiratory Care
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