Evidence map›Paper›PMID 40983845›Full record

ArticleNeurocritical care2026

Safety and Efficacy of Mechanical Insufflation/Exsufflation Cough Assistance for Preventing Postoperative Pneumonia in Neurosurgical Patients: A Combined Physiological and Cohort Study.

Ruihua Zhang, Meizhizi Zhang, Xiaoyu Zhang, Yang Liu, Jingyi Li, Hui Wang, Song Han, Xiufeng Huang, Zhonghua Shi

Abstract read
PubMed Publisher
In one paragraph

Article in Neurocritical care, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Ruihua Zhang *Intensive Care Unit, Department of Neurosurgery, Beijing Sanbo Brain Hospital, Capital Medical University, Beijing, China.
Meizhizi Zhang *Intensive Care Unit, Department of Neurosurgery, Beijing Sanbo Brain Hospital, Capital Medical University, Beijing, China.
Xiaoyu ZhangDepartment of Neurosurgery, Anesthesiology, Beijing Sanbo Brain Hospital, Capital Medical University, Beijing, China.
Yang LiuDepartment of Neurosurgery, Anesthesiology, Beijing Sanbo Brain Hospital, Capital Medical University, Beijing, China.
Jingyi LiIntensive Care Unit, Department of Neurosurgery, Beijing Sanbo Brain Hospital, Capital Medical University, Beijing, China.
Hui WangIntensive Care Unit, Department of Neurosurgery, Beijing Sanbo Brain Hospital, Capital Medical University, Beijing, China.
Song HanDepartment of Neurosurgery, Beijing Sanbo Brain Hospital, Capital Medical University, Beijing, China.
Xiufeng HuangIntensive Care Unit, Department of Neurosurgery, Beijing Sanbo Brain Hospital, Capital Medical University, Beijing, China.
Zhonghua ShiIntensive Care Unit, Department of Neurosurgery, Beijing Sanbo Brain Hospital, Capital Medical University, Beijing, China. z.shi@mail.ccmu.edu.cn.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundPostoperative pneumonia (POP) is a common complication after neurosurgery, leading to worse outcomes. Although mechanical insufflation/exsufflation cough assistance (M-I/E-ca) may improve airway clearance, its safety and efficacy in this patient group remain underexplored. This study aimed to evaluate M-I/E-ca's impact on intracranial pressure (ICP) and hemodynamics and its role in preventing POP.

methodsThis study consisted of two substudies: a prospective physiological study to evaluate ICP and hemodynamic changes and a retrospective-prospective cohort study to assess the incidence of POP. The first substudy enrolled ten patients after neurosurgery, whereas the second included 200 patients, with 100 in the M-I/E-ca group (prospective) and 100 in the control group (retrospective).

resultsM-I/E-ca did not significantly alter ICP or hemodynamic parameters compared with the baseline. Instead, M-I/E-ca caused less disruption in ICP than traditional endotracheal suction, with insufflation/exsufflation pressure set at 40 mm Hg. The incidence of POP was 39%, with lower but not significant incidence in the M-I/E-ca (35%) compared with control (42%) groups (P = 0.309). In addition, patients in the M-I/E-ca group had significantly shorter intensive care unit (P = 0.006) and hospital (P = 0.002) stays compared with those in the control group.

conclusionsM-I/E-ca is safe for patients after neurosurgery, with no significant impact on ICP or hemodynamics. Although it did not significantly reduce POP, it may contribute to shorter intensive care unit and hospital stays, suggesting potential benefits that warrant further investigation in larger studies.

Indexed as

CoughInsufflationIntracranial PressureNeurosurgical ProceduresPneumoniaPostoperative ComplicationsAdultAgedFemaleHemodynamicsHumansMaleMiddle AgedProspective StudiesRetrospective StudiesHemodynamicsIntracranial pressureMechanical insufflation/exsufflation cough assistanceMechanical ventilationNeurosurgeryPostoperative pneumonia

Identifiers

PMID40983845

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

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.