Usefulness of Oscillations Added to Mechanical In-Exsufflation in Amyotrophic Lateral Sclerosis

BACKGROUND: Assisted coughing via mechanical in-exsufflation (MI-E) is a first-line treatment for secretion management in patients with amyotrophic lateral sclerosis (ALS) with unassisted CPF < 4.25 L/s. Some devices enable oscillations to be added to MI-E (MI-E+O). We sought to determine whether...

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Autores: Sancho, Jesus, Bures, Enric, Ferrer, Santos, Bondia, Elvira, Servera, Emilio
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2020
País:España
Institución:INCLIVA
Repositorio:r-INCLIVA. Repositorio Institucional de Producción Científica de INCLIVA
OAI Identifier:oai:incliva.fundanetsuite.com:p4048
Acceso en línea:https://incliva.portalinvestigacion.com/publicaciones/4048
Access Level:acceso abierto
Palabra clave:amyotrophic lateral sclerosis
cough-assist
mechanical insufflation-exsufflation
survival
chest infection
bronchoscopy
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spelling Usefulness of Oscillations Added to Mechanical In-Exsufflation in Amyotrophic Lateral SclerosisSancho, JesusBures, EnricFerrer, SantosBondia, ElviraServera, Emilioamyotrophic lateral sclerosiscough-assistmechanical insufflation-exsufflationsurvivalchest infectionbronchoscopyBACKGROUND: Assisted coughing via mechanical in-exsufflation (MI-E) is a first-line treatment for secretion management in patients with amyotrophic lateral sclerosis (ALS) with unassisted CPF < 4.25 L/s. Some devices enable oscillations to be added to MI-E (MI-E+O). We sought to determine whether adding oscillations to MI-E enables a reduction in the use of invasive secretion management procedures (ie, bronchoscopy or tracheostomy) in subjects with ALS. METHODS: We conducted a 12-month, prospective, randomized follow-up study of subjects with ALS for whom assisted coughing techniques were indicated. One group was treated with oscillations in addition to MI-E (MI-E+O), and the other group was treated with conventional MI-E. RESULTS: 29 subjects were included in the MI-E group and 27 subjects were included in the MI-E+O group. Five subjects (8.9%) required invasive techniques for secretion management (3 in the MI-E group and 2 in the MI-E+O group, P = .70). Treatment with MI-E+O did not alter the risk of invasive procedures (odds ratio 0.69, 95% CI 0.10-4.50, P = .70). The mean number of respiratory infections was 0.58 +/- 0.16 in the MI-E group and 0.025 +/- 0.08 in the MI-E+O group (P = .10). Survival was 8.96 +/- 0.18 months in the MI-E group and 7.70 +/- 0.70 months in the MI-E+O group (P = .10). CONCLUSION: Adding oscillations to MI-E did not enable a reduction in the need to perform invasive procedures for secretion management in subjects with ALS.MARY ANN LIEBERT, INC2020info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionhttps://incliva.portalinvestigacion.com/publicaciones/4048Respiratory CareISSN: 00201324ISSNe: 19433654reponame:r-INCLIVA. Repositorio Institucional de Producción Científica de INCLIVAinstname:INCLIVAInglésinfo:eu-repo/semantics/openAccessoai:incliva.fundanetsuite.com:p40482026-06-07T16:35:31Z
dc.title.none.fl_str_mv Usefulness of Oscillations Added to Mechanical In-Exsufflation in Amyotrophic Lateral Sclerosis
title Usefulness of Oscillations Added to Mechanical In-Exsufflation in Amyotrophic Lateral Sclerosis
spellingShingle Usefulness of Oscillations Added to Mechanical In-Exsufflation in Amyotrophic Lateral Sclerosis
Sancho, Jesus
amyotrophic lateral sclerosis
cough-assist
mechanical insufflation-exsufflation
survival
chest infection
bronchoscopy
title_short Usefulness of Oscillations Added to Mechanical In-Exsufflation in Amyotrophic Lateral Sclerosis
title_full Usefulness of Oscillations Added to Mechanical In-Exsufflation in Amyotrophic Lateral Sclerosis
title_fullStr Usefulness of Oscillations Added to Mechanical In-Exsufflation in Amyotrophic Lateral Sclerosis
title_full_unstemmed Usefulness of Oscillations Added to Mechanical In-Exsufflation in Amyotrophic Lateral Sclerosis
title_sort Usefulness of Oscillations Added to Mechanical In-Exsufflation in Amyotrophic Lateral Sclerosis
dc.creator.none.fl_str_mv Sancho, Jesus
Bures, Enric
Ferrer, Santos
Bondia, Elvira
Servera, Emilio
author Sancho, Jesus
author_facet Sancho, Jesus
Bures, Enric
Ferrer, Santos
Bondia, Elvira
Servera, Emilio
author_role author
author2 Bures, Enric
Ferrer, Santos
Bondia, Elvira
Servera, Emilio
author2_role author
author
author
author
dc.subject.none.fl_str_mv amyotrophic lateral sclerosis
cough-assist
mechanical insufflation-exsufflation
survival
chest infection
bronchoscopy
topic amyotrophic lateral sclerosis
cough-assist
mechanical insufflation-exsufflation
survival
chest infection
bronchoscopy
description BACKGROUND: Assisted coughing via mechanical in-exsufflation (MI-E) is a first-line treatment for secretion management in patients with amyotrophic lateral sclerosis (ALS) with unassisted CPF < 4.25 L/s. Some devices enable oscillations to be added to MI-E (MI-E+O). We sought to determine whether adding oscillations to MI-E enables a reduction in the use of invasive secretion management procedures (ie, bronchoscopy or tracheostomy) in subjects with ALS. METHODS: We conducted a 12-month, prospective, randomized follow-up study of subjects with ALS for whom assisted coughing techniques were indicated. One group was treated with oscillations in addition to MI-E (MI-E+O), and the other group was treated with conventional MI-E. RESULTS: 29 subjects were included in the MI-E group and 27 subjects were included in the MI-E+O group. Five subjects (8.9%) required invasive techniques for secretion management (3 in the MI-E group and 2 in the MI-E+O group, P = .70). Treatment with MI-E+O did not alter the risk of invasive procedures (odds ratio 0.69, 95% CI 0.10-4.50, P = .70). The mean number of respiratory infections was 0.58 +/- 0.16 in the MI-E group and 0.025 +/- 0.08 in the MI-E+O group (P = .10). Survival was 8.96 +/- 0.18 months in the MI-E group and 7.70 +/- 0.70 months in the MI-E+O group (P = .10). CONCLUSION: Adding oscillations to MI-E did not enable a reduction in the need to perform invasive procedures for secretion management in subjects with ALS.
publishDate 2020
dc.date.none.fl_str_mv 2020
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv https://incliva.portalinvestigacion.com/publicaciones/4048
url https://incliva.portalinvestigacion.com/publicaciones/4048
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.rights.none.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.publisher.none.fl_str_mv MARY ANN LIEBERT, INC
publisher.none.fl_str_mv MARY ANN LIEBERT, INC
dc.source.none.fl_str_mv Respiratory Care
ISSN: 00201324
ISSNe: 19433654
reponame:r-INCLIVA. Repositorio Institucional de Producción Científica de INCLIVA
instname:INCLIVA
instname_str INCLIVA
reponame_str r-INCLIVA. Repositorio Institucional de Producción Científica de INCLIVA
collection r-INCLIVA. Repositorio Institucional de Producción Científica de INCLIVA
repository.name.fl_str_mv
repository.mail.fl_str_mv
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