Pneumothorax associated with mechanical insufflation-exsufflation and related factors

Pradeep Suri, Stephen P. Burns, John R. Bach

Research output: Contribution to journalArticlepeer-review

45 Scopus citations

Abstract

Impaired cough that results in ineffective airway secretion clearance is an important contributor to pulmonary complications in patients with neuromuscular weakness including spinal cord injury. Mechanical insufflation-exsufflation (MI-E) is a respiratory aid used by patients with weak respiratory muscles to increase cough peak flows and improve cough effectiveness. Relative contraindications to MI-E are said to include susceptibility to pneumothorax, but the association of pneumothorax with MI-E use has never before been described. We report two cases of pneumothorax in patients with respiratory muscle weakness associated with daily use of MI-E: one was a 58-yr-old male with C4 ASIA C tetraplegia, and the other was a 26-yr-old male with Duchenne muscular dystrophy. Both patients also used positive-pressure ventilatory assistance. Although seemingly rare in this patient population, ventilator users also using MI-E who have increasing dyspnea or who require increasing positive inspiratory pressures when using noninvasive ventilation should be evaluated for pneumothorax.

Original languageEnglish (US)
Pages (from-to)951-955
Number of pages5
JournalAmerican Journal of Physical Medicine and Rehabilitation
Volume87
Issue number11
DOIs
StatePublished - Nov 1 2008

All Science Journal Classification (ASJC) codes

  • Physical Therapy, Sports Therapy and Rehabilitation
  • Rehabilitation

Keywords

  • Adverse effects
  • Cough
  • Insufflation
  • Pneumothorax
  • Spinal cord injuries

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