{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T21:51:29Z","timestamp":1790459489768,"version":"4.1.0"},"reference-count":38,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T00:00:00Z","timestamp":1783641600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Respiratory Care"],"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Mechanical insufflation\u2013exsufflation (MI\u2013E) improves tracheal secretion clearance in patients with neuromuscular disease. Whether it could mitigate the need for tracheal suctioning without altering comfort and safety in intubated patients free of neuromuscular disease admitted in the ICU is unknown.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>Prospective, randomized, crossover open-label study. Intubated patients without preexisting neuromuscular diseases were included. Two tracheal suctioning strategies were compared: suctioning with prior use of MI\u2013E versus standard suctioning. The primary outcome was the number of tracheal suctioning procedures over a 24-h period. Secondary outcomes included sputum volume collected, blood gas, pain, and adverse events related to suctioning.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      The study enrolled 40 subjects over a 2-year period. Out of the 201 tracheal suctioning procedures performed during the 24-h MI\u2013E period, 130 (65%) were actually preceded by the use of MI\u2013E. The number of tracheal suctioning procedures was 5 [3\u20138] during the 24-h MI\u2013E period and 5 [4\u20138] during the 24-h standard suctioning period (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .99). There was no difference between MI\u2013E and the standard suctioning 24-h study periods in terms of the volume of secretions suctioned (10 [5\u201320] mL vs 15 [5\u201328] mL,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .81) and behavioral pain scale (4 [3\u20134] vs 4 [3\u20135],\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .51). There was no difference in terms of blood gas, arterial desaturation, or any adverse events. No pneumothoraces were observed.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>In subjects intubated in the ICU, the systematic use of MI\u2013E before tracheal suctioning did not reduce the number of suctioning procedures but was not associated with a higher prevalence of adverse events.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/19433654261454975","type":"journal-article","created":{"date-parts":[[2026,7,11]],"date-time":"2026-07-11T04:46:53Z","timestamp":1783745213000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Impact of a Mechanical Insufflator\u2013Exsufflation on the Need for Tracheal Suctioning in Intubated Patients"],"prefix":"10.1177","author":[{"given":"Julie","family":"Delemazure","sequence":"first","affiliation":[{"name":"Dr. Delemazure, Morawiec, Mayaux, Decav\u00e8le, Dres, Lecronier, and Prof. Demoule are affiliated with Groupe Hospitalier Universitaire APHP-Sorbonne Universit\u00e9, site Piti\u00e9-Salp\u00eatri\u00e8re, Service de M\u00e9decine Intensive et R\u00e9animation (D\u00e9partement R3S), Paris, France."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Hajage","sequence":"additional","affiliation":[{"name":"Dr. Hajage is affiliated with Sorbonne Universit\u00e9, INSERM, Institut Pierre Louis d\u2019Epid\u00e9miologie et de Sant\u00e9 Publique, AP-HP, H\u00f4pital Piti\u00e9 Salp\u00eatri\u00e8re, D\u00e9partement de Sant\u00e9 Publique, Centre de Pharmaco\u00e9pid\u00e9miologie (Cephepi), Unit\u00e9 de Recherche Clinique PSL-CFX, Paris, France."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elise","family":"Morawiec","sequence":"additional","affiliation":[{"name":"Dr. Delemazure, Morawiec, Mayaux, Decav\u00e8le, Dres, Lecronier, and Prof. Demoule are affiliated with Groupe Hospitalier Universitaire APHP-Sorbonne Universit\u00e9, site Piti\u00e9-Salp\u00eatri\u00e8re, Service de M\u00e9decine Intensive et R\u00e9animation (D\u00e9partement R3S), Paris, France."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julien","family":"Mayaux","sequence":"additional","affiliation":[{"name":"Dr. Delemazure, Morawiec, Mayaux, Decav\u00e8le, Dres, Lecronier, and Prof. Demoule are affiliated with Groupe Hospitalier Universitaire APHP-Sorbonne Universit\u00e9, site Piti\u00e9-Salp\u00eatri\u00e8re, Service de M\u00e9decine Intensive et R\u00e9animation (D\u00e9partement R3S), Paris, France."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maxens","family":"Decav\u00e8le","sequence":"additional","affiliation":[{"name":"Dr. Delemazure, Morawiec, Mayaux, Decav\u00e8le, Dres, Lecronier, and Prof. Demoule are affiliated with Groupe Hospitalier Universitaire APHP-Sorbonne Universit\u00e9, site Piti\u00e9-Salp\u00eatri\u00e8re, Service de M\u00e9decine Intensive et R\u00e9animation (D\u00e9partement R3S), Paris, France."},{"name":"Dr. Decav\u00e8le, Dres, Prof. Similowski, Gonzalez-Bermejo, Demoule are affiliated with UMRS1158 Neurophysiologie Respiratoire Exp\u00e9rimentale et Clinique, Sorbonne Universit\u00e9, INSERM, Paris, France."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin","family":"Dres","sequence":"additional","affiliation":[{"name":"Dr. Delemazure, Morawiec, Mayaux, Decav\u00e8le, Dres, Lecronier, and Prof. Demoule are affiliated with Groupe Hospitalier Universitaire APHP-Sorbonne Universit\u00e9, site Piti\u00e9-Salp\u00eatri\u00e8re, Service de M\u00e9decine Intensive et R\u00e9animation (D\u00e9partement R3S), Paris, France."},{"name":"Dr. Decav\u00e8le, Dres, Prof. Similowski, Gonzalez-Bermejo, Demoule are affiliated with UMRS1158 Neurophysiologie Respiratoire Exp\u00e9rimentale et Clinique, Sorbonne Universit\u00e9, INSERM, Paris, France."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marie","family":"Lecronier","sequence":"additional","affiliation":[{"name":"Dr. Delemazure, Morawiec, Mayaux, Decav\u00e8le, Dres, Lecronier, and Prof. Demoule are affiliated with Groupe Hospitalier Universitaire APHP-Sorbonne Universit\u00e9, site Piti\u00e9-Salp\u00eatri\u00e8re, Service de M\u00e9decine Intensive et R\u00e9animation (D\u00e9partement R3S), Paris, France."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Morgane","family":"Faure","sequence":"additional","affiliation":[{"name":"Dr. Faure and Prof. Similowski are affiliated with AP-HP, Groupe Hospitalier Universitaire APHP-Sorbonne Universit\u00e9, Site Piti\u00e9-Salp\u00eatri\u00e8re, service de pneumologie (D\u00e9partement R3S), Paris, France."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Similowski","sequence":"additional","affiliation":[{"name":"Dr. Decav\u00e8le, Dres, Prof. Similowski, Gonzalez-Bermejo, Demoule are affiliated with UMRS1158 Neurophysiologie Respiratoire Exp\u00e9rimentale et Clinique, Sorbonne Universit\u00e9, INSERM, Paris, France."},{"name":"Dr. Faure and Prof. Similowski are affiliated with AP-HP, Groupe Hospitalier Universitaire APHP-Sorbonne Universit\u00e9, Site Piti\u00e9-Salp\u00eatri\u00e8re, service de pneumologie (D\u00e9partement R3S), Paris, France."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jesus","family":"Gonzalez-Bermejo","sequence":"additional","affiliation":[{"name":"Dr. Decav\u00e8le, Dres, Prof. Similowski, Gonzalez-Bermejo, Demoule are affiliated with UMRS1158 Neurophysiologie Respiratoire Exp\u00e9rimentale et Clinique, Sorbonne Universit\u00e9, INSERM, Paris, France."},{"name":"Prof. Gonzalez-Bermejo is affiliated with AP-HP, Groupe Hospitalier Universitaire APHP-Sorbonne Universit\u00e9, Site Piti\u00e9-Salp\u00eatri\u00e8re, service de soins m\u00e9dicaux de r\u00e9\u00e9ducation respiratoire 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