Clinical Efficacy of In-Line Mechanical Insufflation-Exsufflation in Patients with Invasive Mechanical Ventilation...

This study aimed to evaluate the clinical efficacy of in-line mechanical insufflation-exsufflation (IL-MIE) in airway secretion management in patients receiving invasive mechanical ventilation after cardiopulmonary bypass (CPB).

A total of 56 patients who underwent CPB and required invasive mechanical ventilation in the Cardiac Surgery Intensive Care Unit of Beijing Anzhen Hospital, Capital Medical University, between July 2015 and July 2020, were enrolled and divided into an IL-MIE group (n = 28) and a conventional suction (CS) group (n = 28). The IL-MIE group received automated secretion clearance every 30 min for 8 h, supplemented with CS as needed, whereas the CS group received standard CS treatment. General patient data, respiratory and hemodynamic parameters, ventilator settings, CS frequency, mechanical ventilation duration, and intensive care unit (ICU) length of stay were recorded during the 8 h intervention.

At 4 h and 8 h, the IL-MIE group exhibited significantly higher arterial oxygen partial pressure, oxygenation index, and static compliance and low plateau pressure (p < 0.05). Heart rate was significantly lower in the IL-MIE group at 4 h ((99.21 ± 13.87) vs. (89.32 ± 10.66); p < 0.01) and 8 h ((96.71 ± 14.47) vs. (89.61 ± 9.34); p = 0.033). The IL-MIE group required fewer CS interventions (0 (0, 1) vs. 4 (3, 4); p < 0.01) and had a shorter duration of mechanical ventilation (20 (16.75, 22) vs. 24 (18.75, 26.5); p = 0.029) than those in the CS group.

By mimicking physiological airway clearance, IL-MIE significantly improves oxygenation and lung compliance, reduces the duration of mechanical ventilation, and maintains hemodynamic stability during respiratory management in patients after CPB.