Neuromuscular diseases (NMD) in children are severe, possibly life-threatening orphan conditions. The children are vulnerable and often subject to rapid deterioration of pulmonary function due to impaired ability to clear airway secretions. The use of mechanical cough augmentation with insufflation-exsufflation (MIE) is a strategy to treat and prevent. Possible major benefits are described, but optimal settings for best efficacy and comfort in children are not established. The project aim to improve the quality of the treatment with MIE in children with NMD and weak cough. On the basis of a bench study a clinical trial aims to examine the most effective MIE settings when used in stable state and when respiratory tract infections are present.
On the basis of a prevalence study and a bench study different settings will be studied in children with NMD and weak cough to examine if settings derived from the lung model, are optimal to increase the peak cough flow (PCF) and comfort measured by visual analogue scale (VAS) in children with NMD and weak cough.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
QUADRUPLE
Enrollment
77
Describes settings on the MI-E device
Lower insufflation pressures at longer times
Settings in use at start of study
Helse bergen HF
Bergen, Norway
Oslo university hospital
Oslo, Norway
Stavanger university hospital
Stavanger, Norway
St. Olav Trondheim university hospital
Trondheim, Norway
PCF in the MI-E circuit
Recording of maximal value produced by the MI-E device during Cough
Time frame: 30 minutes.
Patient reported comfort
Comfort rated on a Visual Analog Scale (VAS) (0-100) where 100 is very uncomfortable and 0 is very comfortable.
Time frame: Total time use 30 min
Carbon dioxide
Transcutaneous trend measurement of CO2 during data collection
Time frame: maximal time use is 30 min
Oxygen
Transcutaneous trend measurement of peripheral O2 during data collection
Time frame: maximal time use is 30 min
Hart rate
Transcutaneous trend measurement of hart rate during data collection
Time frame: Total max 30 minutes (During three MI-E trials)
Patient reported efficacy
Efficacy rated on a Visual Analog Scale (0-100) where 100 is not efficient at all and 0 is very efficient.
Time frame: The VAS is recorded after each of the three trials. Total time use 30 min
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