Effect of mechanical insufflation-exsufflation in children with neuromuscular weakness

Esther S Veldhoen, Laura P Verweij-van den Oudenrijn, Leandra A Ros, Erik H Hulzebos, Diana A Papazova, Cornelis K van der Ent, Ludo W van der Pol, Joppe Nijman, Roelie M Wösten-van Asperen

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

INTRODUCTION: Children with neuromuscular diseases develop cough impairment. Airway clearance techniques (ACTs) may help to prevent recurrent respiratory tract infections (RTIs). A commonly used ACT is mechanical insufflation-exsufflation (MI-E), but evidence for efficacy is limited. We hypothesize that MI-E has beneficial effect on RTI related hospital admission rate.

METHODS: In this single-center retrospective study, we reviewed all children who used daily MI-E between 2005 till June 2019. Primary outcome studied was the number of RTIs requiring hospital admission. Patient satisfaction and burden experienced by MI-E use were explored by questionnaires using a Likert scale. The relative number of RTIs requiring admission and the number of admission days per eligible period before and after the introduction of MI-E were compared using the Friedman test and the Wilcoxon signed-rank test.

RESULTS: Thirty-seven children were included. The median number of RTI related hospital admissions per 1000 eligible days after the introduction of MI-E was 0.9 (interquartile range [IQR] 0.0-3.1) compared to the 3 preceding years (median 3.7; IQR 1.4-5.9; P = .006). The median number of RTI related admission days per 1000 eligible days after the introduction of MI-E was significantly lower with a median of 2.7 (IQR 0.0-17.4) compared to the 3 preceding years (median 33.6; IQR 15.0-51.1; P = .001). Patient satisfaction was high with low burden, even in patients who discontinued treatment.

CONCLUSION: A significantly lower number of RTIs requiring hospital admission and shorter admission duration after the introduction of MI-E was found, with high patient satisfaction and low burden.

Original languageEnglish
Pages (from-to)510-513
Number of pages4
JournalPediatric Pulmonology
Volume55
Issue number2
DOIs
Publication statusPublished - Feb 2020

Cite this

Veldhoen, E. S., Verweij-van den Oudenrijn, L. P., Ros, L. A., Hulzebos, E. H., Papazova, D. A., van der Ent, C. K., ... Wösten-van Asperen, R. M. (2020). Effect of mechanical insufflation-exsufflation in children with neuromuscular weakness. Pediatric Pulmonology, 55(2), 510-513. https://doi.org/10.1002/ppul.24614