Abstract
Educational aims
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To raise awareness of how to use mechanical insufflator–exsufflators.
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To discuss the use of mechanical insufflation–exsufflation compared with conventional airway clearance techniques.
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To identify an escalation treatment protocol.
Summary Effective cough is a protective mechanism against respiratory tract infections. In patients with respiratory muscle weakness due to neuromuscular disease, respiratory tract infections are the commonest cause of hospital admission [2]. Neuromuscular disease patients may have impaired cough and a reduction in PCF [3] as a result of inspiratory and expiratory muscle weakness, which causes a reduction in the pressure available to drive the cough manoeuvre [4]. While techniques such as breath stacking and manually assisted coughing can improve cough strength, these eventually become ineffective in some adult and paediatric patients.
- ©ERS 2008