Home Use of Mechanical Insufflation/Exsufflation in Adult Patients in Western Switzerland.
Respiration
; 102(5): 341-350, 2023.
Article
en En
| MEDLINE
| ID: mdl-36724753
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.Palabras clave
Texto completo:
1
Colección:
01-internacional
Banco de datos:
MEDLINE
Asunto principal:
Insuflación
/
Tos
Tipo de estudio:
Observational_studies
/
Prevalence_studies
/
Prognostic_studies
/
Risk_factors_studies
Límite:
Adult
/
Humans
/
Middle aged
País/Región como asunto:
Europa
Idioma:
En
Revista:
Respiration
Año:
2023
Tipo del documento:
Article
País de afiliación:
Suiza