Abstract
Aims & Objectives: Nonpharmacologic secretion clearance therapies became popular in children, but optimal negative pressure and optimal peak cough flow in children are unclear because of poor experience. 69 children (<20-year-old) in our clinic uses Mechanical Insufflator-Exsufflator (MIE) at home (62 CoughAssist E70, 7 ComfortCough Plus). Methods Underlying diagnosis & indication, start age, interface, MIE setting, and MIE complication were chart-reviewed. Daily usage and average Peak Cough Flow were evaluated by build-in SD card. Results (1) Underlying diagnosis: neuromuscular disease, anoxic encephalopathy, and tetraplegia. Indication of MIE is no cough, weak cough and frequent atelectasis. (2) Start age of MIE: 7 year-old (0 - 19 year-old) (3) Interface: mask(17), tracheostomy(52) (4) MIE Setting: Inspiratory Pressure 35cm, Expiratory Pressure 38 cm (5) MIE complication: none (6) Daily usage: 60% patients use MIE every day, average daily cough times is 29 (7) Peak Cough Flow: 131 l/min (50 – 250)Conclusions Peak Cough Flow shows weak correlation (r2=0.3) with age, weight and height. This may be due to wrong MIE setting or poor technique of caregiver. But normal value of Peak Cough Flow was not reported under 4-year-old. We must investigate optimal MIE setting and optimal Peak Cough Flow by clinical effectiveness of secretion clearance.
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