The benefits of mechanical insufflator-exsufflator compared to autogenic drainage in adults with cystic fibrosis

Nir Helper, Einat Kodesh, Gil Sokol, Ran Hakimi, Daphna Vilozni, Ori Efrati

Research output: Contribution to journalArticlepeer-review


Background: Autogenic drainage (AD) is used for airway clearance in individuals with cystic fibrosis (CF). The mechanical insufflator-exsufflator (MI-E) device is commonly used in patients with neuromuscular diseases for airway clearance by increasing inspiratory volume and expiratory flow. MI-E use has not been studied extensively in CF patients. Objectives: To examine whether there are advantages to using the MI-E device in patients with CF. Subjects: Fourteen males and eight females from the national center for CF, with an average FEV1 of 54% were recruited. Design: Prospective cross-over trial (IRB 3009-16-SMC). Intervention: Subjects received either AD or MI-E in a random order. Sputum was collected and weighed immediately after treatment. Subjects performed lung function tests at baseline, 20 minutes after and 1 hour after treatment; additionally, a 2-minute walk test was performed at the end of all lung function tests. Saturation, dyspnea scores while resting and after a 2-minute walk and subjective fatigue were recorded. Results: Thirty-six percent more sputum was collected following MI-E than AD treatment (P <.0001). A significant difference in saturation in response to the 2MWT was noted in both treatments significantly less desaturation was recorded after the 2MWT in the MI-E treatment (P <.01). Conclusions: Treatment with the MI-E was more effective for clearing sputum in CF subjects, initial evidence suggests that the MI-E may be successfully incorporated into treatment protocols. Further studies are needed to assess the long-term benefits of MI-E in patients with CF.

Original languageEnglish
Pages (from-to)3046-3052
Number of pages7
JournalPediatric Pulmonology
Issue number11
StatePublished - 1 Nov 2020

Bibliographical note

Publisher Copyright:
© 2020 Wiley Periodicals LLC


  • airway clearance
  • chest physiotherapy
  • cystic fibrosis
  • lung function
  • mechanical insufflator-exsufflator
  • mucus clearance
  • respiratory physiotherapy
  • Prospective Studies
  • Drainage/methods
  • Humans
  • Male
  • Cystic Fibrosis/physiopathology
  • Cross-Over Studies
  • Young Adult
  • Respiration, Artificial/methods
  • Sputum
  • Adult
  • Female
  • Exhalation
  • Respiratory Function Tests

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Pediatrics, Perinatology, and Child Health


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