Effect of home mechanical in-exsufflation on hospitalisation and life-style in neuromuscular disease: a pilot study

J Paediatr Child Health. 2013 Mar;49(3):233-7. doi: 10.1111/jpc.12111. Epub 2013 Feb 26.


Aim: 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.

Methods: 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.

Results: 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 cmH2 O 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.

Conclusions: Home MI-E use by children with NMD can reduce hospitalisation and benefit families by maintaining their child at home.

MeSH terms

  • Adolescent
  • Child
  • Child, Preschool
  • Female
  • Home Care Services
  • Hospitalization / statistics & numerical data*
  • Humans
  • Infant
  • Insufflation
  • Length of Stay / statistics & numerical data*
  • Life Style*
  • Male
  • Neuromuscular Diseases / complications
  • Neuromuscular Diseases / therapy*
  • Pilot Projects
  • Quality of Life*
  • Retrospective Studies
  • Treatment Outcome