[P2-53] Study on Mechanical Insufflation–Exsufflation (CoughAssist E70) for Patients with Severe Motor and Intellectual Disabilities
[Introduction] We evaluated the safety of using CoughAssist E70 (E70) for patients with severe motor and intellectual disabilities (SMID).
[Subjects and Method] The review period was 6 months from June to November 2015. The subjects were nine patients in our hospital. We observed SpO2, pulse rate, respiratory rate, peak cough flow (PCF), and tidal volume intake (Vti). Actual facial expressions, tension changes, respiratory depression, and vomiting were also examined.
[Results] Five patients were males. The patients were aged 7–39 years (mean, 24.2 years). All patients had undergone tracheotomies; six patients had received ventilator management. The current intake-expiratory pressure used was 10–50 cmH2O (maximum pressure: 35 cmH2O, three patients; 40 cmH2O, three patients; 45 cmH2O, one patient; and 50 cmH2O, two patients). Maximum PCF was 59–222 l/min (<100 l/min in four of nine patients), and maximum Vti was 961–4,300 ml. Significant changes in vital signs were not observed.
[Conclusions] The use of E70 for patients with SMID while monitoring PCF and Vti is safe. In some patients, attaining a PCF of 160 l/min, which has been reported as a valid PCF, was difficult. Hard chest and obstructive / mixed pulmonary disorder were considered to be some of the factors. Further investigation is required on the utility of breath assistance, prone position by manipulation, and accounts of leaks, especially Vti.
[Subjects and Method] The review period was 6 months from June to November 2015. The subjects were nine patients in our hospital. We observed SpO2, pulse rate, respiratory rate, peak cough flow (PCF), and tidal volume intake (Vti). Actual facial expressions, tension changes, respiratory depression, and vomiting were also examined.
[Results] Five patients were males. The patients were aged 7–39 years (mean, 24.2 years). All patients had undergone tracheotomies; six patients had received ventilator management. The current intake-expiratory pressure used was 10–50 cmH2O (maximum pressure: 35 cmH2O, three patients; 40 cmH2O, three patients; 45 cmH2O, one patient; and 50 cmH2O, two patients). Maximum PCF was 59–222 l/min (<100 l/min in four of nine patients), and maximum Vti was 961–4,300 ml. Significant changes in vital signs were not observed.
[Conclusions] The use of E70 for patients with SMID while monitoring PCF and Vti is safe. In some patients, attaining a PCF of 160 l/min, which has been reported as a valid PCF, was difficult. Hard chest and obstructive / mixed pulmonary disorder were considered to be some of the factors. Further investigation is required on the utility of breath assistance, prone position by manipulation, and accounts of leaks, especially Vti.