Person in need of airway cleaning and use of mechanical insufflator-exsufflator device: gains from rehabilitation nursing intervention for people in intensive care

Airway clearance in patients under Invasive Mechanical Ventilation (IMV) or noninvasive mechanical ventilation (NIMV) is a key intervention that should be performed regularly, not only to prevent secretion accumulation, but also to prevent adverse effects that may result from this accumulation of secretions. One of the most relevant interventions in this type of patient is the use of the Mechanical Insufflator-Exsufflator device (MI-E), commonly known as Cough Assist®. On the other hand, Respiratory Functional Rehabilitation (RFR) involves a set of non-invasive procedures that ensure the release of secretions, namely the fluidization of secretions and the use of techniques that allow their mobilization, properly combined with directed and assisted cough teachings. The effectiveness of RFR associated with the use of MI-E yields gains from this conjugation, especially when the person does not collaborate, has decreased muscle strength, or cannot effectively cough. The study conducted in an Intensive Care Unit (ICU) in Portugal shows significant gains in the association of an RFR program with MI-E, with evident improvements in the level of dyspnea, which can be quantified with the implementation of the Modified Borg. At the beginning of the implementation of the RFR program the patients had mild to moderate level of dyspnea and at the end the patients did not have dyspnea. This study made clear the gains that exist for the ICU or NIMV intensive care admission person using MI-E in combination with airway cleaning techniques, in terms of ventilatory performance, airway permeability and decreased complications.