Application of Mechanical Inflation-Exhalation Technique Combined with Manual Assisted Cough in Patients with Tracheostomy and Cervical Spinal Cord Injury Receiving Mechanical Ventilation
Abstract：Objective: To observe the effect of mechanical inflation-exhalation technique (MI-E) combined with manual assisted cough (MAC) in patients with tracheostomy and cervical spinal cord injury receiving mechanical ventilation. Methods: A randomized controlled study was conducted, selecting 64 patients with tracheostomy and cervical spinal cord injury receiving mechanical ventilation admitted to the respiratory intensive care unit (ICU) of Henan Provincial People's Hospital from June 2022 to June 2024 as the study subjects. Four patients withdrew due to changes in their condition, and finally, 30 patients were included in each group. Both groups were set with MI-E inspiratory and expiratory pressures of 40 cmH2O. The control group used a high inspiratory flow setting, while the experimental group used a low inspiratory flow setting and combined MAC during MI-E. Clinical pulmonary infection scores (CPIS), static compliance of the respiratory system (Cst), and oxygenation index (P/F) were observed and compared after one week of treatment. Additionally, electrical impedance tomography (EIT) was used to monitor the change in end-expiratory lung impedance (△EELI) in the dorsal lung regions of both groups. Results: After one week of treatment, the CPIS of the experimental group was significantly lower than that of the control group (P < 0.05). Moreover, the experimental group showed higher Cst, P/F, and △EELI in the dorsal lung region compared to the control group (all P < 0.05). There were statistically significant differences in CPIS, Cst, and P/F between the two groups before and after treatment (all P < 0.05). Conclusion: MI-E combined with MAC can effectively reduce the pulmonary infection score in patients with tracheostomy and cervical spinal cord injury receiving mechanical ventilation, and can more quickly restore collapsed alveoli in the dorsal lung, thereby effectively improving the static compliance of the respiratory system and the oxygenation index.
Keywords：mechanical insufflation-exsufflationcervical spinal cord injuryelectrical impedance technology
Publication Date：2025-07-25
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：4( 2664-2667 )