Patient Preference for ln-Exsufflation for Secretion Management with Spinal Cord Injury

Garstang, Susan V.; Kirshblum, Steven; Wood, Kenneth E.

doi:10.1080/10790268.2000.11753511

Cited by 55 publications

(25 citation statements)

References 14 publications

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“…It involves the application of cycling positive and negative pressure to the airway, facilitating an effective cough and adequate secretion clearance. Studies examining its home-based clinical effectiveness demonstrate that it is safe and well tolerated [2][3][4] ; creates an increased peak cough flow 2,[5][6][7][8] ; results in reduced hospital stay 9 ; and when used as part of a wider home management protocol involving other therapies, such as noninvasive ventilation, achieves reduced rates of pneumonia and hospital stay. 5,6,10,11 However, there have been comparatively few studies examining the broader impact of home-based MI-E on children and their families.…”

Section: Introductionmentioning

confidence: 99%

Lifestyle Implications of Home Mechanical Insufflation-Exsufflation for Children With Neuromuscular Disease and Their Families

Moran¹,

Spittle

Delany

2014

Respir Care

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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. Developing themes from the child interviews showed them adjusting to and then relying on the device. Home MI-E medicalized the home, but the overall lifestyle impact was positive. CONCLUSIONS: Although involving a small number of subjects, this study demonstrated a mixture of opposing impacts of home MI-E on lifestyle, both enabling and disabling, which need to be considered when introducing home MI-E. The positive impacts included greater ability to manage the child's health, including avoidance of hospital admissions. Negative impacts were greatest for those parents who were sole operators of the device, including a frequently disrupted lifestyle.

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Section: Introductionmentioning

confidence: 99%

Lifestyle Implications of Home Mechanical Insufflation-Exsufflation for Children With Neuromuscular Disease and Their Families

Moran¹,

Spittle

Delany

2014

Respir Care

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“…A more recent study indicated comparable inpatient usage experience (51%) and somewhat more prevalent (42%) experience using it with outpatients, although the low response rate in that survey (16%) may have biased those findings (12). Patients typically prefer MIE over suctioning (13), and in outpatient settings the treatments are most commonly administered by family members or other caregivers, not nurses (12). Medical complications associated with the use of MIE appear to be rare (14), although barotrauma is a potential concern in some patient populations given the positive pressure associated with the insufflation phase of MIE.…”

Section: Introductionmentioning

confidence: 84%

Mechanical Insufflation-Exsufflation Device Prescription for Outpatients With Tetraplegia

Crew

Svircev

Burns

2010

The Journal of Spinal Cord Medicine

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Background: Mechanical insufflation-exsufflation (MIE) is an option for secretion mobilization in outpatients with spinal cord injury (SCI) who lack an effective cough and are at high risk for developing pneumonia. Objective: To describe characteristics of persons with SCI who received MIE devices for outpatient use and compare respiratory hospitalizations before and after MIE prescription. Design: Retrospective cohort study of all persons who were prescribed MIE devices for outpatient use during 2000 to 2006 by a Veterans Affairs SCI service. Results: We identified 40 patients with tetraplegia (4.5% of population followed by the SCI service) who were prescribed MIE devices. Of these, 30 (75%) had neurologic levels of C5 or rostral, and 33 (83%) had motor-complete injuries. For chronically injured patients who were prescribed MIE for home use, there was a nonsignificant reduction in respiratory hospitalization rates by 34% (0.314/y before MIE vs 0.208/y after MIE; P 5 0.21). A posthoc subgroup analysis showed a significant decline in respiratory hospitalizations for patients with significant tobacco smoking histories. Conclusions: Mechanical insufflation-exsufflation was typically prescribed for people with motor-complete tetraplegia. Outpatient MIE usage may reduce respiratory hospitalizations in smokers with SCI. Further research of this alternative, noninvasive method is warranted in the outpatient SCI population.

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“…6 Patients found the CoughAssist more effective, less irritating, less painful, less tiring, and more comfortable and convenient than suctioning. 3,6 To date, however, adequate insufflation-exsufflation settings for artificial airways are not well known.…”

Section: Insufflation-exsufflation Via Invasive Interfacementioning

confidence: 99%

“…In recent studies, the CoughAssist was applied to tracheotomized patients with spinal cord injury 3,13 or neuromuscular disease. 6,9 Insufflation-exsufflation was compared to endotracheal suctioning on a cannula with inflated cuff.…”

Section: Insufflation-exsufflation Via Invasive Interfacementioning

confidence: 99%

The Use of Mechanical Insufflation-Exsufflation Via Artificial Airways

Toussaint

2011

Respir Care

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Patient Preference for ln-Exsufflation for Secretion Management with Spinal Cord Injury

Cited by 55 publications

References 14 publications

Lifestyle Implications of Home Mechanical Insufflation-Exsufflation for Children With Neuromuscular Disease and Their Families

Lifestyle Implications of Home Mechanical Insufflation-Exsufflation for Children With Neuromuscular Disease and Their Families

Mechanical Insufflation-Exsufflation Device Prescription for Outpatients With Tetraplegia

The Use of Mechanical Insufflation-Exsufflation Via Artificial Airways

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