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Effective Mechanical Insufflation-Exsufflation in a Patient With Difficulty in Sputum Discharge and Intensive Care

Tadayoshi Nonoyama1,2, Hiroko Shigemi3, Chiaki Yasutake1

  • 1Department of Rehabilitation, University of Fukui Hospital, Fukui, JPN.

Cureus
|March 16, 2022
PubMed

Insights

Mechanical insufflation-exsufflation (MI-E) effectively cleared sputum in a patient with intensive care unit-acquired weakness (ICU-AW). This technique aided in managing airway clearance, though weaning from ventilation may be prolonged.

Area of Science:

  • Critical Care Medicine
  • Pulmonology
  • Physical Therapy

Background:

  • Intensive care unit-acquired weakness (ICU-AW) frequently causes diaphragmatic dysfunction, complicating ventilator weaning.
  • Effective sputum clearance is vital for patients with ICU-AW to prevent respiratory complications.

Observation:

  • A case study highlights a patient experiencing significant difficulty with sputum discharge due to ICU-AW.
  • Conventional methods like postural drainage and bronchoscopic aspiration were insufficient for sputum removal.

Findings:

  • Mechanical insufflation-exsufflation (MI-E) successfully mobilized sputum from peripheral to central airways, reducing the need for bronchoscopic suctioning.
  • MI-E proved essential for managing persistent sputum discharge even after the patient was weaned from mechanical ventilation.

Implications:

  • MI-E presents a valuable therapeutic option for managing sputum retention in patients with ICU-AW.
  • While effective for airway clearance, MI-E may be associated with prolonged ventilator weaning durations in affected patients.

Keywords:
icu-acquired weaknessintensive care unitmechanical insufflation-exsufflationmusculoskeletal rehabilitationrespiratory care

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