Prevalence of long-term mechanical insufflation-exsufflation in children with neurological conditions: a population-based study.
Brit Hov, Tiina Andersen, Michel Toussaint and 4 others
PMID 33393110WHAT IT FOUND
Mechanical insufflation-exsufflation is used by 6 per 1000 children with neurological conditions in Norway.
It is most common in spinal muscular atrophy, but one-third of devices are used by children with central nervous system conditions, often for prophylaxis.
Key findings
01The point prevalence of long-term mechanical insufflation-exsufflation use was 6 per 1000 children in the neuropaediatric population.
02Clinical signs of impaired mucus clearance, such as weak cough or recurrent infections, were the main reason for starting treatment, while prophylactic use was reported more often in neuromuscular disorders.
03More than half of the children using mechanical insufflation-exsufflation also received long-term mechanical ventilation, with concurrent use being much more common in neuromuscular disorders than in central nervous system conditions.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for SLPs
Read the rest of this summary
You get three full summaries a month, free, and we do not ask for a card. Search, the TL;DRs and your library stay unlimited either way.
What it does not show
The study reports prevalence, not incidence, and mortality rates were high (12 of 124 children died shortly before invitation), which may result in an underestimation of prevalence, especially in high-mortality diagnoses. The questionnaire was not formally validated, and data on reasons for initiation were collected retrospectively, introducing recall bias. Private purchase of equipment was not captured, though the authors deem this unlikely in Norway due to state provision. The study is descriptive and cannot determine the appropriateness or efficacy of MI-E treatment. A significant portion of the population was under 6 years old, limiting the ability to perform voluntary objective assessments like peak cough flow.
Declared interests
The paper is supported by non-U.S. government research funding. No specific commercial conflicts of interest or author disclosures are detailed in the provided text, but the study relies on national registries and government-provided equipment.
The easy way to misread this
Do not interpret the high prevalence of MI-E use in children with central nervous system conditions as evidence of its effectiveness for that group. The authors explicitly state this is a descriptive study and that preventive use in CNS conditions appears untargeted, with a need for mandatory clinical trials to evaluate response before long-term use.