Trial reportCritical care (London, England)2012
Effects of mechanical insufflation-exsufflation in preventing respiratory failure after extubation: a randomized controlled trial.
Trial report in Critical care (London, England), 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06202859 (Respiratory Physiotherapy as a Tool to Increase the Number of Solid Organ Donors), which is not on this map. Cited by 41 papers, 4 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Respiratory Physiotherapy as a Tool to Increase the Number of Solid Organ Donors
Who cites it
41 citing papers in PubMed, 4 syntheses or guidelines pooled it.
- Physiological and clinical effects of selected airway clearance techniques in mechanically ventilated adult ICU patients: a systematic review and synthesis without meta-analysis.Critical care (London, England) · 2026Pooled it
- Weaning from mechanical ventilation in ICU patients: research hotspots and trends in the past decade-a bibliometric analysis.Frontiers in medicine · 2026Pooled it
- Use of mechanical insufflation exsufflation and manual techniques in an intubated adult with COVID-19 positioned in prone-A case study.Physiotherapy research international : the journal for researchers and clinicians in physical therapy · 2022Pooled it
- Cough augmentation techniques for extubation or weaning critically ill patients from mechanical ventilation.The Cochrane database of systematic reviews · 2017Pooled it
- Comparison of Mechanical Insufflation-Exsufflation and Hypertonic Saline and Hyaluronic Acid With Conventional Open Catheter Suctioning in Intubated Patients.Respiratory care · 2024Trial
- Trial
- Comparison of bronchial hygiene techniques in mechanically ventilated patients: a randomized clinical trial.Revista Brasileira de terapia intensiva · 2019Trial
- Abdominal functional electrical stimulation to enhance mechanical insufflation-exsufflation.The journal of spinal cord medicine · 2016Trial
- Effects of mechanical in-exsufflation in preventing postextubation acute respiratory failure in intensive care acquired weakness patients: a randomized controlled trial.Critical care scienceTrial
- Tracheostomy Decannulation Practices in Indian Intensive Care Units: A National Cross-sectional Survey of Intensive Care Unit Consultants.Indian journal of critical care medicine : peer-reviewed, official publication of Indian Society of Critical Care Medicine · 2026Article
- Association between abdominal muscle weakness and weaning failure in mechanically ventilated critically ill patients: an ultrasound assessment.Journal of anesthesia, analgesia and critical care · 2026Article
- Expert consensus-based clinical practice guidelines for Care and weaning procedures in tracheostomized ICU patients after invasive mechanical ventilation: a joint statement by the Intensive Care Physiotherapy Society (SKR) and the French Intensive Care Society (SRLF).Annals of intensive care · 2026Article
- Clinical Efficacy of In-Line Mechanical Insufflation-Exsufflation in Patients with Invasive Mechanical Ventilation After Cardiopulmonary Bypass.Reviews in cardiovascular medicine · 2026Article
- A Prospective, Longitudinal Study Evaluating the Efficacy of an Automated Secretion Removal Technology.Respiratory care · 2024Article
- Waves of Precision: A Practical Guide for Reviewing New Tools to Evaluate Mechanical In-Exsufflation Efficacy in Neuromuscular Disorders.Journal of clinical medicine · 2024Review
- Cough flows as a criterion for decannulation of autonomously breathing patients with tracheostomy tubes.Respiratory research · 2024Observational
- Efficacy of an Automated Secretion Removal Technology at Different Inspiratory Pressures.Respiratory care · 2023Article
- Article
- Sonometric assessment of cough predicts extubation failure: SonoWean-a proof-of-concept study.Critical care (London, England) · 2023Article
- Mechanical insufflation-exsufflation to promote extubation success in critically ill adults on intensive care: protocol for a randomised controlled feasibility trial.Pilot and feasibility studies · 2023Article
Corrections and comments
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Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionWeaning protocols that include noninvasive ventilation (NIV) decrease re-intubation rates and ICU length of stay. However, impaired airway clearance is associated with NIV failure. Mechanical insufflation-exsufflation (MI-E) has been proven to be very effective in patients receiving NIV. We aimed to assess the efficacy of MI-E as part of an extubation protocol.
methodPatients with mechanical ventilation (MV) for more than 48 hours with specific inclusion criteria, who successfully tolerated a spontaneous breathing trial (SBT), were randomly allocated before extubation, either for (A) a conventional extubation protocol (control group), or (B) the MI-E extubation protocol (study group). During the postextubation period (48 hours), group A patients received standard medical treatment (SMT), including NIV in case of specific indications, whereas group B received the same postextubation approach plus three daily sessions of mechanical in-exsufflation (MI-E). Reintubation rates, ICU length of stay, and NIV failure rates were analyzed.
resultsSeventy-five patients (26 women) with a mean age of 61.8 ± 17.3 years were randomized to a control group (n = 40; mean SAPS II, 47.8 ± 17.7) and to a study group (n = 35; mean SAPS II, 45.0 ± 15.0). MV time before enrollment was 9.4 ± 4.8 and 10.5 ± 4.1 days for the control and the study group, respectively. In the 48 hours after extubation, 20 control patients (50%) and 14 study patients (40%) used NIV. Study group patients had a significant lower reintubation rate than did controls; six patients (17%) versus 19 patients (48%), P < 0.05; respectively, and a significantly lower time under MV; 17.8 ± 6.4 versus 11.7 ± 3.5 days; P < 0.05; respectively. Considering only the subgroup of patients that used NIV, the reintubation rates related to NIV failure were significantly lower in the study group when compared with controls; two patients (6%) versus 13 (33%); P < 0.05, respectively. Mean ICU length of stay after extubation was significantly lower in the study group when compared with controls (3.1 ± 2.5 versus 9.8 ± 6.7 days; P < 0.05). No differences were found in the total ICU length of stay.
conclusionInclusion of MI-E may reduce reintubation rates with consequent reduction in postextubation ICU length of stay. This technique seems to be efficient in improving the efficacy of NIV in this patient population.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.