A survey examining Mechanical Insufflation-Exsufflation use in UK, adult intensive care units.

Abstract

Background: Despite potential benefits it is not known how widely mechanical insufflation-exsufflation (MI-E) is used by physiotherapists on UK intensive care units (ICU). Aim: To describe the use of MI-E in adult ICUs across the UK. Method: Physiotherapists working on UK, adult ICUs were invited to participate in an electronic survey. Ethical approval was granted by the Faculty Research Ethics Committee, University of the West of England, Bristol. Results: 166 complete surveys were returned, with good geographical UK representation. Over half (72% 119/166) respondents were band 7 and above, with a mean (±SD) of 13 (±7) years since qualification. Nearly all (98% 163/166) clinicians had access to MI-E on ICU, with a range of devices reported. Estimated frequency of use varied; the majority reporting weekly or monthly use (n=52/163, 32% and n=50/163, 31% respectively). Just over half of clinicians (n=86/163, 53%) stated they use MI-E with intubated patients. In contrast, 99% of clinicians stated MI-E use with extubated patients. Of those clinicians who did not use MI-E in intubated patients (n=74/163, 45%), a range of perceived barriers were reported (fig 1). Conclusions: MI-E is widely available on adult ICUs across the UK. Clinicians reported greater use with extubated patients. Barriers to MI-E use in the intubated population warrants further investigation. Figure 1: Perceived barriers to MI-E use in the intubated population