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Mechanical insufflation-exsufflation 
for airway mucus clearance: 
When, how and where.



John Bach, MD

Medical Director, Center for Noninvasive Mechanical Ventilation

Rutgers New Jersey Medical School

Newark, NJ


Coughing is an important component of airway clearance, particularly in individuals with pulmonary disease, respiratory muscle weakness, or central nervous system disease that impairs breathing. The use of an in-exsufflation device to promote airway clearance in individuals with neuromuscular disease is essential to avoid retained secretions that cause infection, inflammation, and respiratory failure. This webinar will focus on the basic theory and clinical goals in the application of an in-exsufflation device, patient selection, indications/contraindications, prescription settings and applications in adults versus pediatric populations.


Learning Objectives:

Upon completion of this activity, the participant will be able to:

  1. Explain how mechanical in-exsufflation devices can make ventilator weaning parameters and spontaneous breathing trials unnecessary.  

  2. Describe how noninvasive mechanical in-exsufflation can be administered safely and effectively. 

  3. Describe the use of pulse oximetry in relation to mechanical in-exsufflation.

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