Upper Airway Assessment and Responses During Mechanically Assisted Cough

Abstract

When ability to cough is impaired, secretion clearance may be assisted and augmented by Mechanical Insufflation-Exsufflation (MI-E). In some individuals, the efficacy of MI-E may be hampered by counterproductive upper airway reactions, where the airways close in response to positive pressures. In order to fully utilize the therapeutic potential inherent in the MI-E technology, we need a better understanding of the pathophysiology behind these untoward reactions. There is an increasing interest in monitoring and measuring upper airway responses to MI-E, and how such information can be used to optimize the MI-E settings. The purpose of this narrative review is to increase the theoretical understanding of larynx as a respiratory organ, summarize the current literature in the area, and provide insight into how this knowledge can affect current clinical practice.