How I Do It: MIE Implementation & Management, Aided by Graphics

Chest · Dec 2023

Review Practice Guideline

How I Do It: MIE Implementation & Management, Aided by Graphics Analysis.

Mechanical insufflation-exsufflation (MIE) facilitates airway clearance to mitigate respiratory infection, decompensation, and ultimately the need for intubation and placement of a tracheostomy tube. Despite widespread adoption as a respiratory support intervention for motor neuron disease, muscular dystrophy, spinal cord injury, and other diseases associated with ventilatory pump failure and ineffective cough peak flow, there is debate in the clinical community about how to optimize settings when MIE is implemented. This article will demonstrate the clinical utility of MIE graphics in titrating the initial MIE settings, guiding upper airway and lung protective strategies and providing insight to clinicians for ongoing clinical management.

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- David A Troxell, John R Bach, and Jon O Nilsestuen.
- Newark, NJ. Electronic address: EFLintrinsic@gmail.com.
- Chest. 2023 Dec 1; 164 (6): 150515111505-1511.
AbstractMechanical insufflation-exsufflation (MIE) facilitates airway clearance to mitigate respiratory infection, decompensation, and ultimately the need for intubation and placement of a tracheostomy tube. Despite widespread adoption as a respiratory support intervention for motor neuron disease, muscular dystrophy, spinal cord injury, and other diseases associated with ventilatory pump failure and ineffective cough peak flow, there is debate in the clinical community about how to optimize settings when MIE is implemented. This article will demonstrate the clinical utility of MIE graphics in titrating the initial MIE settings, guiding upper airway and lung protective strategies and providing insight to clinicians for ongoing clinical management.Copyright © 2023 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.

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How I Do It: MIE Implementation & Management, Aided by Graphics Analysis.

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