[Home use of a mechanical cough-assist insufflation-exsufflation device for adults with neuromuscular diseases who do not require ventilatory support]

Drolet R, Larocque B, Nourissat A, Rhainds M, Lacasse Y
Record ID 32018005135
Original Title: Utilisation à domicile d’un dispositif d’insufflation-exsufflation mécanique d’assistance à la toux pour les adultes atteints de maladies neuromusculaires qui ne requièrent pas d’assistance ventilatoire
Authors' objectives: This evaluation assessed the safety and effectiveness of using a mechanical insufflation-exsufflation (MI-E) device at home in adults with a neuromuscular disease (NMD) in order to inform decision-making on making this type of technology accessible to those who do not require ventilatory support.
Authors' results and conclusions: The literature search revealed a limited quantity and quality of evidence assessing the effect of MI-E devices on respiratory complications and quality of life in patients with NMD, regardless of the participants’ use of ventilatory support. However, the evidence review suggests that the use of MI-E devices may increase cough peak flow (CPF) and they represent a safe alternative, or complementary mode of treatment, for bronchial clearance in adults with NMD, especially when manual cough-assist techniques are ineffective. Although the use of MI-E devices could be beneficial for the management of secretions in certain home dwelling patients who do not require ventilatory support, the evidence currently available is insufficient to conclude on their clinical effectiveness in this population.
Authors' recommendations: the Health Technology Assessment Scientific Steering Committee recommends that the Quebec Heart and Lung Institute – Laval University develop and evaluate, within the framework of a pilot project, a care protocol aimed at making MI-E devices accessible for home use for patients with NMD not eligible for Quebec’s National Home Ventilatory Assistance Program.
Project Status: Completed
Year Published: 2017
English language abstract: There is no English language summary available
Publication Type: Full HTA
Country: Canada
Province: Quebec
MeSH Terms
  • Neuromuscular Diseases
  • Breathing Exercises
  • Cough
  • Self-Help Devices
  • Respiration, Artificial
  • Respiration
  • Insufflation
Organisation Name: Institut universitaire de cardiologie et de pneumologie de Québec – Université Laval (IUCPQ-ULaval)
Contact Address: 2725, chemin Sainte-Foy Québec QC G1V 4G5
Contact Name: uetmis.iucpq@ssss.gouv.qc.ca
Contact Email: uetmis.iucpq@ssss.gouv.qc.ca
Copyright: Institut universitaire de cardiologie et de pneumologie de Québec - Université Laval
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