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The use of mechanical insufflation-exsufflation in invasively ventilated critically ill adults: A scoping review protocol

Swingwood, Ema; Stilma, Willemke; Tume, Lyvonne; Cramp, Fiona; Paulus, Frederique; Schultz, Marcus; Scholte op Reimer, Wilma; Rose, Louise

The use of mechanical insufflation-exsufflation in invasively ventilated critically ill adults: A scoping review protocol Thumbnail


Authors

Ema Swingwood

Willemke Stilma

Lyvonne Tume Lyvonne.Tume@uwe.ac.uk
Associate Professor in Child Health

Fiona Cramp Fiona.Cramp@uwe.ac.uk
Professor in Long Term Conditions

Frederique Paulus

Marcus Schultz

Wilma Scholte op Reimer

Louise Rose



Abstract

© 2020, The Author(s). Background: Critically ill patients receiving invasive ventilation are at risk of sputum retention. Mechanical insufflation-exsufflation (MI-E) is a technique used to mobilise sputum and optimise airway clearance. Recently, interest has increased in the use of mechanical insufflation-exsufflation for invasively ventilated critically ill adults, but evidence for the feasibility, safety and efficacy of this treatment is sparse. The aim of this scoping review is to map current and emerging evidence on the feasibility, safety and efficacy of MI-E for invasively ventilated adult patients with the aim of highlighting knowledge gaps and identifying areas for future research. Specific research questions aim to identify information informing indications and contraindications to the use of MI-E in the invasively ventilated adult, MI-E settings used, outcome measures reported within studies, adverse effects reported and perceived barriers and facilitators to using MI-E reported. Methods: We will search electronic databases MEDLINE, EMBASE, CINAHL using the OVID platform, PROSPERO, The Cochrane Library, ISI Web of Science and the International Clinical Trials Registry Platform. Two authors will independently screen citations, extract data and evaluate risk of bias using the Mixed Methods Appraisal Tool. Studies included will present original data and describe MI-E in invasively ventilated adult patients from 1990 onwards. Our exclusion criteria are studies in a paediatric population, editorial pieces or letters and animal or bench studies. Search results will be presented in a PRISMA study flow diagram. Descriptive statistics will be used to summarise quantitative data. For qualitative data relating to barriers and facilitators, we will use content analysis and the Theoretical Domains Framework (TDF) as a conceptual framework. Additional tables and relevant figures will present data addressing our research questions. Discussion: Our findings will enable us to map current and emerging evidence on the feasibility, safety and efficacy of MI-E for invasively ventilated critically ill adult patients. These data will provide description of how the technique is currently used, support healthcare professionals in their clinical decision making and highlight areas for future research in this important clinical area. Systematic review registration: Open Science Framework submitted on 9 July 2020.https://osf.io/mpksq/.

Citation

Swingwood, E., Stilma, W., Tume, L., Cramp, F., Paulus, F., Schultz, M., …Rose, L. (2020). The use of mechanical insufflation-exsufflation in invasively ventilated critically ill adults: A scoping review protocol. Systematic Reviews, 9(1), https://doi.org/10.1186/s13643-020-01547-8

Journal Article Type Article
Acceptance Date Nov 26, 2020
Online Publication Date Dec 8, 2020
Publication Date Dec 8, 2020
Deposit Date Dec 14, 2020
Publicly Available Date Jan 6, 2021
Journal Systematic Reviews
Print ISSN 2046-4053
Electronic ISSN 2046-4053
Publisher BioMed Central
Peer Reviewed Peer Reviewed
Volume 9
Issue 1
Article Number 287
DOI https://doi.org/10.1186/s13643-020-01547-8
Keywords Medicine (miscellaneous)
Public URL https://uwe-repository.worktribe.com/output/6953872
Additional Information Received: 15 July 2020; Accepted: 26 November 2020; First Online: 8 December 2020; : Not applicable.; : Not applicable.; : The authors declare that they have no competing interests.

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