{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T03:40:29Z","timestamp":1791344429491,"version":"4.3.1"},"reference-count":22,"publisher":"S. Karger AG","issue":"3","license":[{"start":{"date-parts":[[2014,1,1]],"date-time":"2014-01-01T00:00:00Z","timestamp":1388534400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.karger.com\/Services\/SiteLicenses"},{"start":{"date-parts":[[2014,1,1]],"date-time":"2014-01-01T00:00:00Z","timestamp":1388534400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.karger.com\/Services\/SiteLicenses"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Respiration"],"published-print":{"date-parts":[[2014]]},"abstract":"<jats:p>&lt;b&gt;&lt;i&gt;Background:&lt;\/i&gt;&lt;\/b&gt; Mechanical insufflation-exsufflation (MI-E), more commonly known as \u2018cough assist therapy', is a method which produces inspiratory and expiratory assistance to improve cough performances. However, other alternatives or combinations are possible. &lt;b&gt;&lt;i&gt;Objective:&lt;\/i&gt;&lt;\/b&gt; The objective was to compare the effects of mechanical insufflation combined with manually assisted coughing (MAC), insufflation-exsufflation alone and insufflation-exsufflation combined with MAC in neuromuscular patients requiring cough assistance. &lt;b&gt;&lt;i&gt;Methods:&lt;\/i&gt;&lt;\/b&gt; Eighteen neuromuscular patients with severe respiratory muscle dysfunction and peak cough flow (PCF) lower than 3 liters\/s or maximal expiratory pressure (MEP) lower than +45 cm H&lt;sub&gt;2&lt;\/sub&gt;O were studied. Patients were studied under three cough-assisted conditions, which were used in random order: insufflation by intermittent positive-pressure breathing (IPPB) combined with MAC, MI-E and MI-E + MAC. &lt;b&gt;&lt;i&gt;Results:&lt;\/i&gt;&lt;\/b&gt; Overall, PCF was higher with IPPB + MAC than with MI-E + MAC or MI-E alone. Among the 12 patients who had higher PCF values with IPPB + MAC than with the two other techniques, 9 exhibited mask pressure swings during MI-E exsufflation, with a transient positive-pressure value due to the expiratory flow produced by the combined patient cough effort and MAC. Each of these 9 patients had higher PCF values (&gt;5 liters\/s) than did the other 9 patients when using IPPB + MAC. &lt;b&gt;&lt;i&gt;Conclusion: &lt;\/i&gt;&lt;\/b&gt;Our results indicate that adding the MI-E device to MAC is unhelpful in patients whose PCF with an insufflation technique and MAC exceeds 5 liters\/s. This is because the expiratory flow produced by the patient's effort and MAC transitorily exceeds the vacuum capacity of the MI-E device, which therefore becomes a transient load against the PCF.<\/jats:p>","DOI":"10.1159\/000364911","type":"journal-article","created":{"date-parts":[[2014,9,9]],"date-time":"2014-09-09T07:51:41Z","timestamp":1410249101000},"page":"215-222","source":"Crossref","is-referenced-by-count":67,"title":["Comparison of Three Cough-Augmentation Techniques in Neuromuscular Patients: Mechanical Insufflation Combined with Manually Assisted Cough, Insufflation-Exsufflation Alone and Insufflation-Exsufflation Combined with Manually Assisted Cough"],"prefix":"10.1159","volume":"88","author":[{"given":"Matthieu","family":"Lacombe","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lorena","family":"Del Amo Castrillo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aur\u00e9lien","family":"Bor\u00e9","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Chapeau","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric","family":"Horvat","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isabelle","family":"Vaugier","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michelle","family":"Lejaille","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Orlikowski","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H\u00e9l\u00e8ne","family":"Prigent","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fr\u00e9d\u00e9ric","family":"Lofaso","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"127","published-online":{"date-parts":[[2014,8,21]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.00182208"},{"key":"ref2","doi-asserted-by":"publisher","DOI":"10.1378\/chest.110.6.1566"},{"key":"ref3","doi-asserted-by":"publisher","DOI":"10.1186\/cc11249"},{"key":"ref4","doi-asserted-by":"publisher","DOI":"10.1097\/00002060-200207000-00007"},{"key":"ref5","doi-asserted-by":"publisher","DOI":"10.1136\/thx.2008.110726"},{"key":"ref6","doi-asserted-by":"publisher","DOI":"10.1378\/chest.104.5.1553"},{"key":"ref7","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.99.14614189"},{"key":"ref8","doi-asserted-by":"publisher","DOI":"10.1378\/chest.118.1.61"},{"key":"ref9","doi-asserted-by":"publisher","DOI":"10.1097\/PHM.0b013e31817fb26f"},{"key":"ref10","doi-asserted-by":"publisher","DOI":"10.1136\/thx.53.11.949"},{"key":"ref11","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.03.00048102"},{"key":"ref12","doi-asserted-by":"publisher","DOI":"10.1378\/chest.78.3.463"},{"key":"ref13","doi-asserted-by":"publisher","DOI":"10.1016\/j.resp.2005.01.001"},{"key":"ref14","doi-asserted-by":"publisher","DOI":"10.1002\/ppul.20406"},{"key":"ref15","doi-asserted-by":"publisher","DOI":"10.1136\/thorax.56.6.438"},{"key":"ref16","doi-asserted-by":"publisher","DOI":"10.1378\/chest.125.4.1400"},{"key":"ref17","doi-asserted-by":"publisher","DOI":"10.3109\/17482968.2010.535541"},{"key":"ref18","doi-asserted-by":"publisher","DOI":"10.1212\/01.WNL.0000092018.56823.02"},{"key":"ref19","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp.74.12.1685"},{"key":"ref20","doi-asserted-by":"publisher","DOI":"10.1378\/chest.94.6.1232"},{"key":"ref21","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD010044.pub2"},{"key":"ref22","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.05.00034805"}],"container-title":["Respiration"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.karger.com\/Article\/Pdf\/364911","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.karger.com\/Article\/Pdf\/364911","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,4,23]],"date-time":"2025-04-23T17:53:01Z","timestamp":1745430781000},"score":1,"resource":{"primary":{"URL":"https:\/\/karger.com\/article\/doi\/10.1159\/000364911"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2014]]},"references-count":22,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2014,9,1]]},"published-print":{"date-parts":[[2014,9,15]]}},"URL":"https:\/\/doi.org\/10.1159\/000364911","archive":["Portico"],"relation":{},"ISSN":["0025-7931","1423-0356"],"issn-type":[{"value":"0025-7931","type":"print"},{"value":"1423-0356","type":"electronic"}],"subject":[],"published":{"date-parts":[[2014]]}}}