Abstract
BACKGROUND: The Nippy Clearway is a new mechanical insufflation-exsufflation device used to assist cough.
METHODS: We compared the peak expiratory flow (PEF) with the Nippy Clearway versus the CoughAssist in a bench experiment. The relationship between PEF and pressure at the airway opening during exsufflation (minimum expiratory PAO) was investigated under 6 combinations of compliance (30 or 60 mL/cm H2O) (C30 and C60) and resistance (0, 5, or 20 cm H2O/L/s) (R0, R5, and R20) over a 25–50 cm H2O range of set PAO. The intercepts and slopes of the linear regression performed over PEF and PAO relationships were compared for both devices.
RESULTS: For the C30R0, C30R5, and C60R5 conditions, the change in both the intercepts and slopes was significant with the Nippy Clearway, compared to the CoughAssist, averaging −2.96 L/s and −0.03 L/s/cm H2O, −1.46 L/s and 0.02 L/s/cm H2O, and −1.02 L/s and −0.04 L/s/cm H2O, respectively. As a result, at any minimum expiratory PAO, PEF was significantly greater with the Nippy Clearway. For C30R20 and C60R20, the regression lines were similar for the Nippy Clearway and CoughAssist.
CONCLUSIONS: In this bench study, PEF with the Nippy Clearway was greater than with the CoughAssist at low respiratory-system compliance.
Footnotes
- Correspondence: Claude Guérin MD PhD, Service de Réanimation Médicale, Hôpital de la Croix Rousse, 103 Grande Rue de la Croix Rousse, 69004 Lyon, France. E-mail: claude.guerin{at}chu-lyon.fr.
The authors have disclosed no conflicts of interest.
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