Yasokawa Naoya, Tanaka Hitomi, Kurose Koji, Abe Masaaki, Oga Toru
Department of Respiratory Medicine, Kawasaki Medical School, Japan.
Respir Med Case Rep. 2020 Feb 4;29:101017. doi: 10.1016/j.rmcr.2020.101017. eCollection 2020.
Mechanical insufflation-exsufflation (MI-E) devices are frequently used in patients with respiratory muscle weakness to increase their cough peak flow and assist them in improving cough effectiveness and clearing mucus from the airways. An 89-year-old male was admitted to our university hospital due to fever and loss of appetite. He was diagnosed with lung abscess and pulmonary nontuberculous mycobacterial disease. He was unable to independently expectorate phlegm due to frailty. Subsequently, MI-E was introduced. On day 3 after its introduction, chest X-ray examination revealed bilateral pneumothorax, and use of the MI-E device was discontinued. After conservatively observing the clinical course, pneumothorax was improved on day 12 after it occurred. Although scientific evidence regarding MI-E is currently limited, healthcare professionals often do not have an alternative in clinical practice. However, treating physicians should consider the risk of MI-E-related pneumothorax, despite its low occurrence rate.
机械通气辅助排痰（MI-E）设备常用于呼吸肌无力患者，以增加其咳嗽峰值流速，并帮助他们提高咳嗽有效性，清除气道黏液。一名89岁男性因发热和食欲不振入住我院。他被诊断为肺脓肿和非结核分枝杆菌肺病。由于身体虚弱，他无法自主咳痰。随后，引入了MI-E设备。在使用该设备后的第3天，胸部X线检查显示双侧气胸，遂停用MI-E设备。在保守观察临床过程后，气胸在发生后的第12天有所改善。尽管目前关于MI-E的科学证据有限，但医疗保健专业人员在临床实践中往往没有其他选择。然而，尽管MI-E相关气胸的发生率较低，但治疗医生仍应考虑其风险。
