Cough Augmentation Techniques for Weaning in Critically Ill Patients from Mechanical Ventilation

Abstract

Abstract Background Retained sputum conflicts the weaning trial, as well as increase the risk of chest infection and prolong the time on mechanical ventilation Objective To evaluate the impact of using mechanical exsufflators insufflators as cough augmentation technique on outcome of weaning, in addition to assessing the rate of successful weaning using NIV and T-tube mode. Methods A randomizes control trial that included 30 patients divided into 2 groups; the first weaned by NIV mode, the second by T-tube mode. All patients prepared equally for spontaneous breathing trial (SBT), and using ME-I frequently just before SBT. Results The rate of successful weaning in all cases was 66.6% (20 patients of 30), the rate was higher in groups that weaned by T-tube than NIV mode (86.67% versus 46.67%), P = 0.01. Moreover, the number of ME-I cycle was significantly higher in group with successful weaning than other group, P = 0.02.In addition, the ventilation support time was significantly longer in failed group than the successful one, P < 0.001. Conclusion The use of MI-E just before the weaning trial enhance the outcome of weaning, moreover, the weaning trial by T-tube mode gave a higher successful rate during spontaneous breathing trial (SBT).