Mechanical insufflation-exsufflation: Practice patterns among respiratory therapists in Ontario

S Prevost, Dina Brooks, Phillip T Bwititi

Research output: Contribution to journalArticlepeer-review

6 Citations (Scopus)
14 Downloads (Pure)


BACKGROUND:The mechanical insufflator-exsufflator (MIE) is effective in assisting cough and in helping to avoid unplanned hospitalizations, tracheostomy and long-term ventilation in patients with neuromuscular disease or spinal cord injury. Despite this, the availability and usage of the device in Canada is unknown.
OBJECTIVE: To investigate practice patterns and availability of the MIE in Ontario hospitals.
METHODS: A cross-sectional, self-administered mail survey was sent to a random sample of 400 respiratory therapists practicing in 96 Ontario hospitals.
RESULTS: A total of 114 (28%) completed surveys were returned from 62 (65%) hospitals. Twenty (32%) hospitals had a MIE. The respiratory therapist was the predominant health care provider using the MIE. The device was most commonly used in the intensive care unit, and medical/ surgical units in patients with neuromuscular diseases or spinal cord injuries. Optimal pressure spans of 35 cmH2O to 40 cmH2O were used by 54% of respondents. Fourteen of the 20 hospitals with an MIE had policies or guidelines in place, and four of these hospitals had established staff competencies. Measurements of peak cough flow, maximal inspiratory/expiratory
pressure and vital capacity were reported to be infrequently performed.
CONCLUSIONS: The present study demonstrated that the MIE device is not widely available in Ontario hospitals and there are variations in how the devices are applied, possibly resulting in suboptimal therapy. A comprehensive educational program about MIE devices that incorporates best practices and a practical component is recommended for current providers as well as for inclusion in student curricula.
Original languageEnglish
Pages (from-to)33-38
Number of pages6
JournalCanadian Journal of Respiratory Therapy
Issue number2
Publication statusPublished - 2015

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