| Title: |
Impact of a Mechanical Insufflator-Exsufflator on the Need for Tracheal Suctioning in Intubated Patients – A Prospective Randomized Crossover Trial |
| Authors: |
Demoule, A.; Hajage, D.; Morawiec, E.; Mayaux, J.; Decavèle, M.; Dres, M.; Lecronier, M.; Faure, M.; Similowski, T.; Gonzalez Bermejo, J.; Delemazure, J. |
| Source: |
American Journal of Respiratory and Critical Care Medicine ; volume 211, issue Supplement_1, page A1223-A1223 ; ISSN 1073-449X 1535-4970 |
| Publisher Information: |
Oxford University Press (OUP) |
| Publication Year: |
2025 |
| Description: |
Background. Mechanical insufflation-exsufflation (MI-E) improves tracheal secretion clearance in patients with neuromuscular disease. Whether it could mitigate the need for tracheal suctioning without altering comfort and safety in intubated patients in the intensive care unit (ICU) is unknown. Methods. Prospective, randomized, cross-over open label single blinded study. Intubated patients without pre-existing neuromuscular diseases were included. Two tracheal suctioning strategies were compared: suctioning with prior use of MI-E vs. standard suctioning. The primary outcome was the number of tracheal suctioning over a 24-hour period. Secondary outcomes included sputum volume collected, blood gas, pain and oxygen desaturation related to suctions. Results. The study enrolled 40 patients over a 2-years period. Out of the 201 tracheal suctioning procedures performed during the MI-E period, 130 (65%) were actually preceded by the use of the MI-E by mistake. The number of tracheal suctioning procedures was 5 [3-8] during the 24-hour MI-E period and 5 [4-8] during the 24-hour standard suctioning period (p=0.992). There was not difference between the MI-E and the standard suctioning 24-hour study periods in terms of the volume of secretions (10 [5-20] ml vs. 15 [5-28] ml, p = 0.812) and behavioural pain scale (4 [3-4] vs. 4 [3-5], p = 0.512). There was no difference in terms of blood gas. The proportion of patients who presented at least one episode of arterial desaturation during tracheal suctioning was higher during the 24-hour MI-E period than during the standard suctioning period (81% vs. 57%, p=0.008). No pneumothorax was observed. Conclusion. In patients intubated in the ICU, the systematic use of MI-E before each tracheal suctioning procedure does not reduce the number of suctioning but is associated with a higher incidence of arterial desaturation. |
| Document Type: |
article in journal/newspaper |
| Language: |
English |
| DOI: |
10.1164/ajrccm.2025.211.abstracts.a1223 |
| Availability: |
https://doi.org/10.1164/ajrccm.2025.211.abstracts.a1223; https://academic.oup.com/ajrccm/article-pdf/211/Supplement_1/A1223/67026476/ajrccm_211_abstracts_a1223.pdf |
| Rights: |
https://academic.oup.com/pages/standard-publication-reuse-rights |
| Accession Number: |
edsbas.665B95B8 |
| Database: |
BASE |