Effect of home mechanical in-exsufflation on hospitalisation and life-style in neuromuscular disease: A pilot study
- Conflict of interest: All authors have no conflicts of interest to disclose.
- This study was performed at The Royal Children's Hospital, Melbourne, Australia.
- No funding was received for this study.
Correspondence: Miss Fiona CE Moran, Department of Physiotherapy, Royal Children's Hospital, Flemington Road, Parkville, Vic. 3052, Australia. Fax: +613 9359 1546; email: firstname.lastname@example.org
Mechanical in-exsufflation (MI-E) augments the weakened cough of patients with neuromuscular disease (NMD), clearing secretions and overcoming atelectasis. Little has been published on the impact of MI-E alone on rates of hospitalisation and quality of life (QOL). The aim of this study was to assess the impact of home MI-E on hospital admissions and life-style in children with NMD.
A retrospective chart review was performed on children using MI-E, including data on the number of admissions to hospital, length of stay and hours of ventilation. A parental survey was used to gather information on the impact of MI-E on life-style for the child and family.
Ten children with NMD (seven spinal muscular atrophy, two Duchenne muscular dystrophy and one centronuclear myopathy) using MI-E at home were identified. MI-E use commenced at mean age of 8.5 years (range 1.1–16.9) with 1.4 years of use (range 0.3–3.8). MI-E pressures ranged from +/−30 to 40 cmH2O with no complications reported. There was a significant reduction in hospital days at 6 (P = 0.036) and 12 (P = 0.028) months following commencement of home MI-E compared with the same period preceding MI-E use. The survey highlighted positive benefits of MI-E use, in particular the ability to treat many pulmonary exacerbations at home.
Home MI-E use by children with NMD can reduce hospitalisation and benefit families by maintaining their child at home.