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Scientific article
Open access
English

Home Use of Mechanical Insufflation/Exsufflation in Adult Patients in Western Switzerland

Published inRespiration, vol. 102, no. 5, p. 341-350
First online date2023-02-01
Abstract

Background: Mechanical insufflation/exsufflation (MI-E) devices are often prescribed to patients with inefficient cough and recurrent infections, but their use in the home setting is not well characterized.

Objective: The objective of this study was to report a real-life experience and identify factors that are associated with home MI-E use in adult patients.

Methods: This is a cross-sectional observational study of adult subjects with neurological disease using MI-E at home for more than 3 months.

Results: A total of 43 patients were included. Median age (interquartile range) was 48 (31-64) years. The most common diagnosis was muscular dystrophy (n = 15), followed by multiple sclerosis (n = 7) and amyotrophic lateral sclerosis (n = 7). 24 subjects (56%) reported using the MI-E at least once weekly. Based on device data downloads, the median objective use was 23% of days analysed (approximately 2 times per week). The vast majority (94%) of all participants reported using the device at least daily during an infectious episode, while 62% reported having used the device in emergency situations such as bronchoaspiration. Reported use correlated well with objective use (r = 0.82). Most subjects reported an improvement in their respiratory health (64%) and were satisfied with the device (78%). Higher reported and objective use were associated with increased symptoms (p = 0.001) and higher satisfaction with the device (p = 0.008). We found no association between frequency of use and baseline cough peak flow (CPF), bulbar impairment, non-invasive ventilation use, living environment, or supervised administration.

Conclusion: Regular home MI-E use was associated with greater symptom burden and overall satisfaction with the device and was not influenced by baseline CPF. Patients without substantial bronchorrhea might not use the MI-E regularly but might still need to use the device at home during acute events. Therefore, familiarity with the MI-E via appropriate and repeated practical training is crucial.

eng
Keywords
  • Cough assistance
  • Mechanical insufflation-exsufflation
  • Neurological disease
  • Neuromuscular disease
  • Humans
  • Adult
  • Middle Aged
  • Cough
  • Insufflation
  • Cross-Sectional Studies
  • Switzerland
  • Respiration, Artificial
Citation (ISO format)
MITROPOULOU, Georgia et al. Home Use of Mechanical Insufflation/Exsufflation in Adult Patients in Western Switzerland. In: Respiration, 2023, vol. 102, n° 5, p. 341–350. doi: 10.1159/000529166
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Identifiers
ISSN of the journal0025-7931
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Technical informations

Creation10/20/2023 12:35:57 PM
First validation11/10/2023 7:49:23 AM
Update time11/10/2023 7:49:23 AM
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