Effectiveness of mechanical insufflation-exsufflation device in pediatric patients with cystic fibrosis

Coughing is the body’s defense mechanism to clear the airways from the foreign bodies and secretions. In patients with neuromuscular disorders or other diseases affecting the airways such as cystic fibrosis (CF), the effectiveness of this defense mechanism is often reduced due to respiratory exhaustion. The aim of our study was to evaluate the effectiveness of mechanical insufflation-exsufflation device (MI-E) in pediatric patients with CF. Materials and Methods: In this study, we randomized 31 patient’s whit CF admitted to the pediatric pulmonary ward of Masih Daneshvari hospital (Tehran – Iran) into two groups of routine physiotherapy (including an active cycle of breathing technique, pursed-lips breathing, diaphragmatic/abdominal breathing, huffing, and coughing) or, routine physiotherapy plus 10 sessions of MI-E, each for 20 minutes. MI-E pressure was set +5 to +30 cmH2O for inspiration and -8 to -33 for expiration, for 1-3 and 3-5 seconds, respectively. Two groups were then compared regarding the results of the 6-minute walk test (distance), spirometry, echocardiography, and arterial blood gases. Results: The mean age of the patients was 16.4± 4.6 years and 16 (23.6%) were male. Results of the analysis demonstrated that there were no significant differences between the two groups. Our results demonstrated similar efficacy for conventional physiotherapy versus physiotherapy and MI-E regarding the improvement of pulmonary function and airway clearance in CF patients.