Performance of the CoughAssist Insufflation-Exsufflation Device in the Presence of an Endotracheal Tube or Tracheostomy Tube: A Bench Study

Bench Assessment of a New Insufflation-Exsufflation Device

“…Nippy Clearway was superior to CoughAssist in terms of PEF under low compliance and resistance. In a previous bench study with a similar setup 6 we measured PEF generated with CoughAssist, and, compared to the results from that study, the present PEF values are 0.60 L/s greater. It is likely that this difference comes from the use of a different device.…”

Respiratory muscle aids to avert respiratory failure and tracheostomy: a new patient management paradigm

“…Deep insufflations followed immediately by deep exsufflations at pressures of 40 to −40 mmHg (54.1 cm H 2 O) are usually the most effective and preferred. The MI-E can be provided via an oral-nasal mask, a simple mouthpiece, or a translaryngeal or tracheostomy tube, in which case there is a considerable pressure drop-off and diminution of air flows, 29 but it is still effective in clearing airway secretions and preparing patients for extubation or decannulation. 30 When delivered via the latter, the cuff, when present, should be inflated and pressures of 50-70 cm H 2 O used.…”

The Use of Mechanical Insufflation-Exsufflation Via Artificial Airways

“…21 In the current issue of RESPIRATORY CARE, Guérin et al 23 report an in vitro study of insufflation-exsufflation with the CoughAssist, with several sizes of endotracheal and tracheostomy tube, and with several lung model compliance and resistance settings. Their study did not aim at showing any evidence on the effectiveness of insufflationexsufflation technology, but at measuring the impact of artificial airways on expiratory flows and volumes.…”

“…The additional finding that an increase in airway resistance or decrease in thoraco-pulmonary compliance decreased the expiratory cough flow is consistent with previous findings by Sancho and co-workers. 10 Interestingly, Table 5 from Guérin et al 23 suggests the pressures necessary to generate effective assisted expiratory flows under various conditions of resistance and compliance as a function of artificial airway tube diameter. These data are relevant for clinicians because they provide a tool that is immediately useful in clinical practice in the intensive care unit.…”

“…The addition of knowledge on insufflation-exsufflation recently accelerated, as evidenced by 10 original studies published during the last 4 years. [14][15][16][17][18][19][20][21][22][23] The particularity of insufflation-exsufflation is that it provides a mechanical assistance to compensate for deficits in both the inspiratory and expulsive phase of cough in patients with low respiratory muscle strength. Often associated with noninvasive mechanical ventilation, 1,19,22 insufflation-exsufflation is used in adults, children, and even infants.…”