Which therapy method is recommended for improving cough effectiveness in patients with impaired inspiratory capacity?

Insufflation/exsufflation therapy is particularly beneficial for improving cough effectiveness in patients with impaired inspiratory capacity. This method uses a mechanical device to deliver a positive pressure breath (insufflation) followed by a rapid negative pressure breath (exsufflation), which can help mobilize secretions and enhance the effectiveness of cough. It assists in expanding the lungs and clearing mucus, making it advantageous for patients who may struggle with adequate coughing due to their compromised ability to take deep breaths or generate effective cough force.

Patients with impaired inspiratory capacity often have difficulty generating the necessary airflow and pressure needed for effective coughing. The insufflation/exsufflation approach directly addresses this challenge by providing assistance in both phases of the cough mechanism, ultimately leading to improved airway clearance.

Other methods may benefit cough effectiveness, but they may not be as tailored to patients with significant inspiratory capacity limitations. PEP therapy, for instance, primarily helps maintain airway patency and encourages collateral ventilation rather than directly improving cough strength. Flutter-valve therapy is useful for secretion clearance but does not specifically enhance inspiratory function or cough effectiveness. Direct coughing techniques depend on the patient’s ability to take deep breaths and generate enough force, which may be inadequate in those with limited inspiratory capacity