Official websites use. Share sensitive information only on official, secure websites. Introduction : Mechanical Insufflation-Exsufflation MI-E by using a specific device is commonly used to increase weak cough, as in patients with chronic neuromuscular weakness or in intensive care unit ICU patients with ICU-acquired neuro-myopathy. Upper airways collapse is frequently associated with neuromuscular disease and may compromise MI-E efficacy.
The goal of present study was to carry out a bench study to assess the effect of MI-E on PCF with and without the presence of a collapsible tube. Our hypothesis was that PCF was lower with than without collapsible tube. Flow and pressure were proximal to the lung simulator. Six C-R combinations were tested, each with and without the collapsible tube. MI-E device was set in automatic mode with inspiratory time of 3 s, expiratory time of 3.
Each set was recorded by using a data logger Biopac , Biopac inc. The peak expiratory flow during the first ms after onset of expiration was taken as the surrogate of PCF. The corresponding pressure was also recorded. Results : Contrary to our hypothesis, the peak expiratory flow during the first ms of exsufflation phase is higher with than without the collapsible tube in every C-R condition, as shown in figure 1.
For the other conditions, the collapsible tube significantly increased PCF at 30 cm H 2 O expiratory pressure and the gap further increased above this pressure because the slope increased with the collapsible tube.
Conclusion : We found that peak expiratory was higher with than without collapsible tube. In vivo measurements in patients should be done to confirm this finding. Introduction : Background. Current literature and French guidelines recommend early mobilization in Intensive Care Units ICU , including verticalization and walking. Verticalization for neurologic patients in ICU is challenging because of neurological impairments, risks of falls and of clinical worsening.
