Evaluating the use of the CoughAssist E70 by inpatient physiotherapists

Abstract

Background: Mechanical Insufflation:Exsuffflation (MI:E) is a method of airway clearance for patients with an ineffective cough. The CoughAssist E70 (Phillips Respironics, Murraysville, USA) has manual and automatic modes with the addition of oscillations and peak cough flow (PCF) monitoring. A PCF of >270L/min is considered effective. Aim: To analyse the effectiveness of MI:E prescriptions used by physiotherapists to inform an education training programme. Methods: Data were collected between November 2016 and January 2017. A clinician’s survey was completed for patients treated with MI:E, stating diagnosis and clinical indication. Survey responses were amalgamated with data from device secure digital (SD) cards to identify settings used and PCF achieved. Results: 26 clinician surveys were returned, with 12 SD cards interpreted through DirectView software (Philips Respironics, Murraysville, USA). 53.8% of treatment sessions were performed for secretion clearance, 11.5% for secretion clearance plus atelectasis, 30.8% as prophylaxis for patients with motor neurone disease, and 3.9% for atelectasis alone. Use included intubated and tracheostomised patients. Manual mode was utilised in 71.3% and Auto mode in 7.14% of treatment sessions. Additionally, 21.4% of treatment sessions used Auto-Cough Trak function and 21.4% oscillations. Mean± inspiratory pressure prescription was 34.2±3.3, expiratory pressure 37.3±5.6 with a median PCF of 189.3 (IQR 145,228). Conclusion: Despite MI:E PCF remained