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J Spinal Cord Med. 2010;33(2):128-34.

Mechanical insufflation-exsufflation device prescription for outpatients with tetraplegia.

Author information

1
Spinal Cord Injury Service, Veterans Affairs Puget Sound Health Care System, Seattle, Washington, USA. jdcrew@gmail.com

Abstract

BACKGROUND:

Mechanical insufflation-exsufflation (MIE) is an option for secretion mobilization in outpatients with spinal cord injury (SCI) who lack an effective cough and are at high risk for developing pneumonia.

OBJECTIVE:

To describe characteristics of persons with SCI who received MIE devices for outpatient use and compare respiratory hospitalizations before and after MIE prescription.

DESIGN:

Retrospective cohort study of all persons who were prescribed MIE devices for outpatient use during 2000 to 2006 by a Veterans Affairs SCI service.

RESULTS:

We identified 40 patients with tetraplegia (4.5% of population followed by the SCI service) who were prescribed MIE devices. Of these, 30 (75%) had neurologic levels of C5 or rostral, and 33 (83%) had motor-complete injuries. For chronically injured patients who were prescribed MIE for home use, there was a nonsignificant reduction in respiratory hospitalization rates by 34% (0.314/y before MIE vs 0.208/y after MIE; P = 0.21). A posthoc subgroup analysis showed a significant decline in respiratory hospitalizations for patients with significant tobacco smoking histories.

CONCLUSIONS:

Mechanical insufflation-exsufflation was typically prescribed for people with motor-complete tetraplegia. Outpatient MIE usage may reduce respiratory hospitalizations in smokers with SCI. Further research of this alternative, noninvasive method is warranted in the outpatient SCI population.

PMID:
20486531
PMCID:
PMC2869274
DOI:
10.1080/10790268.2010.11689687
[Indexed for MEDLINE]
Free PMC Article

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