RT Journal Article
SR Electronic
T1 Comparison of Four Mechanical Insufflation-Exsufflation Devices: Effect of Simulated Airway Collapse on Cough Peak Flow
JF Respiratory Care
FD American Association for Respiratory Care
SP 462
OP 469
DO 10.4187/respcare.10086
VO 68
IS 4
A1 Terzi, Nicolas
A1 Vaugier, Isabelle
A1 Guérin, Claude
A1 Prigent, Hélène
A1 Boussaid, Ghilas
A1 Leroux, Karl
A1 Delorme, Mathieu
A1 Lofaso, Frédéric
A1 Louis, Bruno
YR 2023
UL http://rc.rcjournal.com/content/68/4/462.abstract
AB BACKGROUND: Mechanical insufflation-exsufflation (MI-E) devices are used to improve airway clearance in individuals with acute respiratory failure. Some MI-E devices measure cough peak flow (CPF) during MI-E to optimize pressure adjustments. The aim was to compare CPF and effective cough volume (ECV: volume expired/coughed > 3 L/s) measurements between 4 MI-E devices under simulated conditions of stable versus collapsed airway.METHODS: Four MI-E devices were tested on the bench. Each device was connected via a standard circuit to a collapsible tube placed in an airtight chamber that was attached to a lung model with adjustable compliance and resistance. Pressure was measured upstream and downstream the collapsing tube; air flow was measured between the chamber and the lung model. Each device was tested in 2 conditions: collapse condition (0 cm H2O) and no-collapse condition (−70 cm H2O). For each condition, 6 combinations of inspiratory/expiratory pressures were applied. CPF was measured at the “mouth level” by the device built-in flow meter and at the “tracheal level” by a dedicated pneumotachograph. Comparisons were performed with non-parametric tests.RESULTS: CPF values measured at the tracheal level and ECV values differed between devices for each inspiratory/expiratory pressure in the collapse and no-collapse conditions (P < .001). CPF values were significantly lower at the tracheal level in the collapse as compared with the no-collapse condition (P < .001 for each device), whereas they were higher at the mouth level (P < .05) for 3 of the 4 devices.CONCLUSIONS: CPF values differed significantly across MI-E devices, highlighting limitation(s) of using only CPF values to determine cough effectiveness. In simulated of airway collapse, CPF increased at the mouth, whereas it decreased at the tracheal level.