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Mechanical in- exsufflation

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https://www.readbyqxmd.com/read/28410251/association-of-need-for-tracheotomy-with-decreasing-mechanical-in-exsufflation-flows-in-amyotrophic-lateral-sclerosis
#1
John R Bach, Neelam Upadhyaya
Although patients with lower motor neuron and myopathic disorders can prolong their lives by depending on continuous noninvasive ventilatory support, most patients with amyotrophic lateral sclerosis (ALS) cannot and must use tracheostomy mechanical ventilation to prolong survival. This case demonstrates that this occurs because amyotrophic lateral sclerosis patients' upper motor neuron reflex laryngeal closure and stridor cause upper airway collapse that renders mechanical insufflation-exsufflation (MIE) ineffective in expulsing airway secretions as well as for permitting continuous noninvasive ventilatory support...
April 13, 2017: American Journal of Physical Medicine & Rehabilitation
https://www.readbyqxmd.com/read/28356637/rate-of-oral-intake-and-effects-of-mechanical-insufflation-exsufflation-on-pulmonary-complications-in-patients-with-duchenne-muscular-dystrophy
#2
Toshihiko Miura, Akiyoshi Takami, Misato Makino, Akira Ishikawa, Yuka Ishikawa
[Purpose] In Duchenne muscular dystrophy, it increases risks of difficulties of expectoration of secretion, asphyxia, aspiration pneumonia because of decreased cough function. The aim of this study is to prove that manually assisted coughing or mechanical insufflation-exsufflation prevents pulmonary complication and contribute to continue oral intake safely and continue rate of oral intake in Duchenne muscular dystrophy. [Subjects and Methods] We investigated the status of using ventilator, manually assisted coughing or mechanical insufflation-exsufflation, and oral intake or not...
March 2017: Journal of Physical Therapy Science
https://www.readbyqxmd.com/read/28338488/respiratory-complications-management-and-treatments-for-neuromuscular-disease-in-children
#3
MyMy C Buu
PURPOSE OF REVIEW: To summarize current literature describing the respiratory complications of neuromuscular disease (NMD) and the effect of respiratory interventions and to explore new gene therapies for patients with NMD. RECENT FINDINGS: Measurements of respiratory function focus on vital capacity and maximal inspiratory and expiratory pressure and show decline over time. Management of respiratory complications includes lung volume recruitment, mechanical insufflation-exsufflation, chest physiotherapy and assisted ventilation...
March 23, 2017: Current Opinion in Pediatrics
https://www.readbyqxmd.com/read/28220822/pulmonary-outcomes-following-specialized-respiratory-management-for-acute-cervical-spinal-cord-injury-a-retrospective-analysis
#4
E C Zakrasek, J L Nielson, J J Kosarchuk, J D Crew, A R Ferguson, S L McKenna
STUDY DESIGN: Retrospective analysis. OBJECTIVES: To identify multivariate interactions of respiratory function that are sensitive to spinal cord injury level and pharmacological treatment to promote strategies that increase successful liberation from mechanical ventilation. SETTING: United States regional spinal cord injury (SCI) treatment center. METHODS: Retrospective chart review of patients consecutively admitted to Santa Clara Valley Medical Center between May 2013 and December 2014 for ventilator weaning with C1-C5 American Spinal Injury Association Impairment Scale (AIS) A or B SCI, <3 months from injury and who had a tracheostomy in place...
February 21, 2017: Spinal Cord
https://www.readbyqxmd.com/read/28196385/-comparison-of-different-mechanical-insufflator-exsufflator-systems-by-measurement-of-the-peak-exspiratory-flow-pef
#5
Ansgar Schütz, Janine Wagner, Anne Conrad, Andreas Funke
Background The management of pulmonary secretion in patients with respiratory muscle weakness using mechanical insufflator-exsufflator systems (MIE) is an established treatment option. There are significant differences in the efficiency of different devices in practical use. The intention of this study was to evaluate the peak exspiratory flow (PEF) values of different devices with and without use of equipment. Methods PEFs of ten MIE were investigated in vitro using different equipment. Results The efficiency of the devices showed significant differences...
March 2017: Pneumologie
https://www.readbyqxmd.com/read/28108686/use-of-mechanical-insufflation-exsufflation-devices-for-airway-clearance-in-subjects-with-neuromuscular-disease
#6
REVIEW
Catherine Auger, Vanessa Hernando, Hubert Galmiche
The aim of this systematic review is to examine the benefit/risk ratio of the use of mechanical insufflation-exsufflation (MI-E) devices for airway clearance in patients with neuromuscular diseases. A search was conducted for relevant studies in MEDLINE, the Cochrane Library, and the Health Technology Assessment Database using the main key words: cough, airway clearance, in-exsufflation. The search limits were studies published in English and French between 1970 and 2014 (literature watch until December 2015)...
February 2017: Respiratory Care
https://www.readbyqxmd.com/read/28075489/cough-augmentation-techniques-for-extubation-or-weaning-critically-ill-patients-from-mechanical-ventilation
#7
REVIEW
Louise Rose, Neill Kj Adhikari, David Leasa, Dean A Fergusson, Douglas McKim
BACKGROUND: There are various reasons why weaning and extubation failure occur, but ineffective cough and secretion retention can play a significant role. Cough augmentation techniques, such as lung volume recruitment or manually- and mechanically-assisted cough, are used to prevent and manage respiratory complications associated with chronic conditions, particularly neuromuscular disease, and may improve short- and long-term outcomes for people with acute respiratory failure. However, the role of cough augmentation to facilitate extubation and prevent post-extubation respiratory failure is unclear...
January 11, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28029527/-improved-lung-function-in-cystic-fibrosis-using-mechanical-insufflation-exsufflation
#8
Laura Azahara Fuentes, Pilar Caro, Antonio Jose Garcia-Ruiz, Gregorio Muñoz Gómez, Elisa Martín-Montañez
No abstract text is available yet for this article.
October 28, 2016: Anales de Pediatría: Publicación Oficial de la Asociación Española de Pediatría (A.E.P.)
https://www.readbyqxmd.com/read/27999675/mechanical-insufflation-exsufflation-for-an-individual-with-duchenne-muscular-dystrophy-and-a-lower-respiratory-infection
#9
Emma Koenig, Bhajan Singh, Jamie Wood
Duchenne muscular dystrophy (DMD) is an X-linked recessive myopathy associated with progressive muscle weakness and wasting, loss of ambulation, respiratory insufficiency, weak cough, repeated respiratory infections, and ultimately death from respiratory failure in early adulthood. Mechanical insufflation-exsufflation (MI-E) devices, such as the CoughAssist®, are used in individuals with neuromuscular weakness to augment cough and help clear secretions; however, there is no consensus on the optimal treatment regimen...
March 2017: Respirology Case Reports
https://www.readbyqxmd.com/read/27624630/cough-augmentation-techniques-in-the-critically-ill-a-canadian-national-survey
#10
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
#11
RANDOMIZED CONTROLLED TRIAL
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
#12
REVIEW
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...
August 9, 2016: BMC Palliative Care
https://www.readbyqxmd.com/read/27507176/respiratory-care-received-by-individuals-with-duchenne-muscular-dystrophy-from-2000-to-2011
#13
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
#14
REVIEW
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...
December 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
#15
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
#16
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...
March 2017: Thorax
https://www.readbyqxmd.com/read/27118611/quantitation-of-oxygen-induced-hypercapnia-in-respiratory-pump-failure
#17
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
#18
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
#19
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...
November 2016: Journal of Spinal Cord Medicine
https://www.readbyqxmd.com/read/26363734/respiratory-management-of-patients-with-fukuyama-congenital-muscular-dystrophy
#20
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
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