In convolution 9 Number 4 there was...

In convolution 9 Number 4 there was an error in the conclusion of the abstract through Sammon et al. We apologize for any inconvenience this error may have caused.

A PILOT CLINICAL INVESTIGATION COMPARING THE general intents OF THE MECHANICAL IN-EXSUFFLATOR TO SUCTIONING AND CHEST PHYSICAL THERAPY IN bodily forms WITH DIFFICULTY MOBILIZING PULMONARY SECRETIONS.

Sammon K

Menon s

Massery M

Callalin L

Schwab Rehabilitation Hospital, Chicago, IL and Sargent literary institution [i]or[/i] seminary of learning Boston University, Boston, MA.

PURPOSE: The design of this study was to determine if the Mechanical InExsufflator (MI-F) is at least as effective as traditional airway clearance techniques as it was as tracheal suctioning (TS) and chest physical therapy (CPT) in individuals with difficulty mobilizing pulmonary secretions. The MI-E was originally unraveled by Barach, Beck, and Smith (term "The Cof-flator": OEM Co Norwalk, Conn) in tile 1950's as a non-invasive manner to assist airway secretion clearance for bodys with poliomyelitis. The MI-E directs positive air urgency into the lungs (insufflation) and abates the air (and secretions) from the lung via a change from positive to negative hurry (creating a vacuum effect: exsufflation). Our hypothesis was that the MI-E would be al least as effective as T and CPT in bodys with difficulty mobilizing pulmonary secretions. SUBJECTS: 17 living bodys (13 males, 4 females: mean+/-SD: age=42+/-20 years) with a variety of neurological and medical/surgical conditions (number of patients with tracheostomies = 11) in a rehabilitation setting who had impairments in airway clearance or lung expansion as determined by way of one or more of the following: 1) decreased pulmonary function, 2) decreased oxygen saturation, 3) abnormal breath unimpaireds and 4) patient complaints of congestion or breathing difficulty. METHODS:

The MI-E OH Emerson Cambridge, MA) was attached to patients via tubing attached to a face mask or a tracheostomy adapter. The insufflation and exsufflation phase durations were approximately 3-5 secondarys each with therapeutic pressures between 30-45 cm H20 The phase durations and constraining forces were adjusted for each patient based with patient comfort and secretion clearance effectiveness. Each treatment session lasted approximately 20 minutes. T was performed using standard sterile techniques. CPT consisted of hard breathing exercises, assisted coughing techniques, exercise, or increased functional activity. Patient comfort and forces of MI-E, TS, and CPT were evaluated (via oxygen saturation, heart rate, posterity pressure, auscultation, and pulmonary function) before, during, and after treatments.

ANALYSIS: Statistical analyses consisted of calculation of means and standard deviations as well as analysis of variance (ANOVA) and Tukey's proof to determine if differences existed among the tenors of MI-E, TS, or CPT concerning the study outcome measures (oxygen saturation, heart rate, life-blood pressure, and pulmonary function). The means and the mean percent change of each issue measure from each method to mobilize secretions for each patient were used in the ANOVA. RESULTS: 84 treatments were performed with the MI-E in 17 patients, 27 T treatments were performed in 9 of the 17 patients, and 56 CPT treatments were performed in 15 of the 17 patients. No significant difference was set among the different methods to mobilize pulmonary secretions for all of the issue measures. CONCLUSION: Treatment with the MI-E produc changes in oxygen saturation, heart rate, kin pressure, and pulmonary function that were not significantly different from the changes produc through TS or CPT. Furthermore, 100% of patients who were able to compile a questionnaire after the studious mood preferred MI-E rather than suctioning. The precedence for MI-E may be owing to its non-invasive nature, the ability of the patient to participate in the MI-E treatment, and the patients perceptions that their secretions were more completely cleared with MI-E.

RELEVANCE: The MI-E was effective and well tolerated according to the patients in this meditation and has the potential to be les expensive since it does not require sterile techniques and uses reusable composings all of which make MI-E a viable alternative for secretion removal. However, coming events study of a larger population of bodily forms with difficulty mobilizing pulmonary secretions is extremityed

Copyright Cardiopulmonary Physical Therapy Journal Spring 1999

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