The effect of mechanical insufflation – exsufflation on spinal cord injury patients with respiratory problems. A systematic scoping review

  • H. Kaliva
  • J. Vlamis
Keywords: spinal cord injuries, quadriplegia, tetraplegia, mechanical insufflation - exsufflation, cough assist


Respiratory dysfunction remains a significant cause of morbidity and mortality after spinal cord injury (SCI).

The purpose of this scoping review is to investigate the effectiveness of mechanical insufflation - exsufflation (MI-E) device, for cough augmentation and secretion management, in patients with SCI.

Electronic databases Medline (pubmed), Cochrane, PEDro, DynaMed, CINALH, and electronic libraries Scopus, ScienceDirect and Google Scholar were searched for relevant literature.

Inclusion criteria concerned studies referring to traumatic spinal cord injuries, carried out from 1/1/2000 until 9/12/2021, written in English language. All types of articles were accepted. Studies on children, animals and neuromuscular diseases as well as book chapters and article abstracts were excluded.

The articles were searched systematically. Fifteen studies were found to meet the inclusion criteria. The search revealed 1 randomized control trial (RCT), 5 retrospective studies, 2 cross-sectional studies, 3 observational studies and 4 case reports.

The reviewed evidence of the utilization of MI-E device resulted to improved pulmonary parameters, shorter hospitalization and successful weaning in patients with SCIs. Although, the reviewed evidence is weak and limited, in clinical practice the usage of MI-E device in patients with SCIs, is encouraging.


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Author Biographies

H. Kaliva

Postgraduate Training Program, 3rd Department of Orthopaedic Surgery,

J. Vlamis

3RD Department of Orthopaedic Surgery, National and Kapodistrian University of Athens, KAT Hospital, Athens, Greece


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