PT  - JOURNAL ARTICLE
AU  - Ema Swingwood
AU  - Alex Harvey
AU  - Sarah Rand
TI  - How do mechanical insufflation:exsufflation (MI:E) settings influence flow rates and sputum movement? A bench study using a paediatric lung model
DP  - 2014 Sep 01
TA  - European Respiratory Journal
PG  - P4301
VI  - 44
IP  - Suppl 58
4099  - http://erj.ersjournals.com/content/44/Suppl_58/P4301.short
4100  - http://erj.ersjournals.com/content/44/Suppl_58/P4301.full
SO  - Eur Respir J2014 Sep 01; 44
AB  - Background:Cough is an essential defence mechanism. Paediatric patients with neuromuscular disease may have reduced cough effectiveness, causing an increased risk of regular chest infections. Cough augmentation strategies are essential to maintain health; MI:E is one such technique used in this patient group. To date studies have examined the effects of MI:E pressure and time settings. It is not known what the effect of repeated insufflations has on generated flow rates. There are no studies to date that have used the NIPPY Clearway MI:E device.Objectives: To examine the effects of repeated insufflations on generated flow rates and sputum movement, using the NIPPY Clearway in a paediatric test lung model.Methods: MI:E was attached to a paediatric test lung. Resulting flows, pressures and volumes, and sputum movement were measured at the airway opening of the test lung at 3 set I:E ratios (1:1, 3:1 and 5:1). The effects of repeated insufflations on generated flow rates and sputum movement were analysed using ANOVA and regression analysis.Results: A significant reduction was found between set and generated insufflation pressures (p<0.001). Repeated insufflations had a significant influence on generated flow rates (p<0.001), and a non significant influence on sputum movement.Conclusions: Increasing insufflation repetitions during MI:E created an inspiratory flow bias; this has the potential to further embed secretions when tested in a paediatric test lung model. Whether these results can be extrapolated into a clinical environment is an area that requires further investigation.