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The Emerson CoughAssist™ Mechanical In-Exsufflator (MI-E) assists patients in
clearing retained bronchopulmonary secretions by gradually applying a positive
pressure to the airway, then rapidly shifting to a negative pressure. This rapid
shift in pressure, via a facemask, mouthpiece or an endotracheal or tracheostomy
tube, produces a high expiratory flow rate from the lungs, simulating a cough, a
technique referred to as “mechanical insufflation-exsufflation.” The automatic
CoughAssist MI-E (CA-3000, CA-3200) has timing mechanisms to automate the
inspiratory and expiratory cycles as well as a manual control. The manual
CoughAssist MI-E (CM-3000, CM-3200) uses a manually operated valve to shift
from positive to negative pressure and back.
Those who might benefit from the use of the CoughAssist MI-E include any patient
with an ineffective cough due to muscular dystrophy, myasthenia gravis, poliomyelitis,
or other neurologic disorder with some paralysis of the respiratory muscles, such
as spinal cord injury. It may also be used to treat ineffective cough due to other
bronchopulmonary diseases, such as emphysema, cystic fibrosis and bronchiectasis.
It is effective for both trached and non-invasively ventilated patients.
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Indications for Use: Any patient unable to cough or clear secretions effectively
due to reduced peak cough expiratory flow (less than 2 to 3 liters per second),
resulting from high spinal cord injuries, neuro-muscular deficits or severe
fatigue associated with intrinsic lung disease, is a candidate for this device.
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Contraindications: Any patient with a history of bullous emphysema,
known susceptibility to pneumothorax or pnuemo-mediastinum, or known to
have had any recent barotrauma, should be carefully considered before use.
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