Does use of the cough assist machine reduce respiratory morbidity for children with neuromuscular disease?

Abstract

The role of the cough assist machine (CAM) in the long term respiratory management of children with neuromuscular disease (NMD) is unclear. This study examined the impact of regular, home use of the CAM on the respiratory status of six children with NMD and significant respiratory morbidity. Individualised CAM programmes were devised to be undertaken regularly. Retrospective review of hospital records was undertaken to obtain admission data, lung function data, community antibiotic prescriptions and chest radiology reports for the two years prior to CAM initiation. These data were compared to data collected for two years following CAM initiation. Fewer days hospitalised for respiratory infections following machine initiation were evident for all participants. Qualitative feedback indicated high treatment compliance and satisfaction. Four of the five participants, with persistent or recurrent chest radiology abnormalities on enrolment, achieved resolution. Half of the participants had a reduction in community antibiotic prescriptions. No adverse events were reported. Acknowledging the small sample size, domiciliary use of the CAM appears a safe and effective form of airway clearance for some children with NMD. In addition, CAM’s may potentially reduce respiratory admission time for some children with severe respiratory morbidity as a result of their NMD. Furthermore an impact on radiological abnormalities and community antibiotic prescriptions may also be possible.