Mechanical Insufflation-Exsufflation vs. Tracheal Suctioning via Tracheostomy Tubes for Patients with Amyotrophic Lateral Sclerosis: A Pilot Study
Abstract
OBJECTIVE: To compare the effects of mechanical insufflation-exsufflation vs. suctioning via tracheostomy tubes on respiratory variables for six amyotrophic lateral sclerosis patients. DESIGN: In this prospective crossover study, six consecutive patients with amyotrophic lateral sclerosis who required continuous mechanical ventilation via tracheostomy tubes and developed chest infections underwent measurement of pulse oxyhemoglobin saturation (SpO2), peak inspiratory pressure (PIP), mean airway pressure (Pawm), and work of breathing performed by the ventilator (WOBv) at baseline and 5 and 30 min after tracheal suctioning and 5 min after mechanical insufflation-exsufflation. RESULTS: The baseline values were 93.50 +/- 2.26% for SpO2 in ambient air, 18.50 +/- 4.23 cm H2O for PIP, 4.67 +/- 1.37 cm H2O for Pawm, and 1.03 +/- 0.25 J/liters for WOBv. Only WOBv changed significantly, decreasing after tracheal suctioning (P < 0.05), whereas all variables improved significantly after mechanical insufflation-exsufflation. CONCLUSION: For ventilator-dependent patients with amyotrophic lateral sclerosis, mechanical insufflation-exsufflation via a tracheostomy tube with an inflated cuff may be more effective in eliminating airway secretions than conventional tracheal suctioning.
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Mechanical insufflation-exhalation applied to the tracheostomy cannula in ALS patients undergoing invasive home mechanical ventilation is an effective procedure for managing bronchial secretions.
“Mechanical insufflation-exhalation (MI-E) applied to the tracheostomy cannula in patients with amyotrophic lateral sclerosis (ALS) undergoing invasive home mechanical ventilation is an effective procedure for managing bronchial secretions [53].”
From Life Experiences in Neuromuscular Tracheotomized Patients in Times of Covid-19 (2023) · cites this paper as [53]
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Airway clearance techniques in neuromuscular disorders: A state of the art review
Chatwin, M., Toussaint, M., Gonçalves, M. R., Sheers, N., Mellies, U., Gonzales-Bermejo, J., Sancho, J., Fauroux, B., Andersen, T., Hov, B., et al. (2018) · Respiratory Medicine · doi:10.1016/j.rmed.2018.01.012 · Cited by 325 · see citing works
Self-citationLife Experiences in Neuromuscular Tracheotomized Patients in Times of Covid-19
Volpato, E., Pierucci, P., De Candia, M. L., Casparrini, M., Volpi, V., Pagnini, F., Carpagnano, G. E., & Banfi, P. (2023) · Journal of Neuromuscular Diseases · doi:10.3233/jnd-221597 · Cited by 2 · see citing works
- Authors
- Sancho, J., Servera, E., Vergara, P., & Marín, J.
- Affiliations
- Universitat de València (ES)
- Corresponding author
- Sancho, Jesús
- ORCID
- Sancho, Jesús
- Venue
- American Journal of Physical Medicine & Rehabilitation
- Published
- 2003-10
- Volume
- 82
- Issue
- 10
- Pages
- 750-753
- ISSN
- 0894-9115 (ISSN-L)
- OpenAlex
- W2071794888
- Cited by
- 93
- References
- 18
- Citations by year
- 2026: 3 · 2025: 2 · 2024: 4 · 2023: 3 · 2022: 3 · 2021: 5 · 2020: 3 · 2019: 3 · 2018: 6 · 2017: 4 · 2016: 6 · 2015: 3 · 2014: 6 · 2013: 2 · 2012: 2
- FWCI
- 2.66
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- American Journal of Physical Medicine & Rehabilitation (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Respiratory Support and Mechanisms
- Health Sciences › Medicine › Neurology › Amyotrophic Lateral Sclerosis Research
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Tracheal and airway disorders
- Keywords
- amyotrophic lateral sclerosis, mechanical insufflation-exsufflation, endotracheal suctioning, tracheostomy tube, ventilator-dependent patients, airway secretion clearance, work of breathing, peak inspiratory pressure, chest infection, continuous mechanical ventilation
- MeSH terms
- Amyotrophic Lateral Sclerosis, Female, Humans, Insufflation, Intubation, Intratracheal, Male, Middle Aged, Oximetry, Pilot Projects, Prospective Studies, Respiration, Artificial, Respiratory Insufficiency, Suction, Tracheostomy, Work of Breathing, Treatment Outcome, Cross-Over Studies
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