Effects of Mechanical Insufflation-Exsufflation on the Breathing Pattern in Stable Subjects With Duchenne Muscular Dystrophy: “A Step Into New Knowledge”

We thank Drs Toussaint, Goncalves, and Chatwin for their interest in our paper.[1][1] However, we do not think that our results may in any way create confusion or change the main focus and outcomes of mechanical insufflation-exsufflation (MI-E) treatment. On the contrary, as underlined by Joshua

[1]  J. Benditt.  Mechanical Insufflation-Exsufflation: More Than Just Cough Assist , 2018, Respiratory Care.

[2]  Andrea Aliverti,et al.  Acute Effects of Mechanical Insufflation-Exsufflation on the Breathing Pattern in Stable Subjects With Duchenne Muscular Dystrophy , 2018, Respiratory Care.

[3]  G. Rodríguez-Trigo,et al.  Preliminary experience on the safety and tolerability of mechanical “insufflation-exsufflation” in subjects with artificial airway , 2018, Intensive Care Medicine Experimental.

[4]  Carla M Bann,et al.  Diagnosis and management of Duchenne muscular dystrophy, part 2: respiratory, cardiac, bone health, and orthopaedic management , 2018, The Lancet Neurology.

[5]  J. Sancho,et al.  Effect of High-Frequency Oscillations on Cough Peak Flows Generated by Mechanical In-Exsufflation in Medically Stable Subjects With Amyotrophic Lateral Sclerosis , 2016, Respiratory Care.

[6]  Su Zhang,et al.  An estimation of mechanical stress on alveolar walls during repetitive alveolar reopening and closure. , 2015, Journal of applied physiology.

[7]  U. Schara,et al.  Mechanical insufflation/exsufflation improves vital capacity in neuromuscular disorders , 2015, Chronic respiratory disease.

[8]  R. Vialle,et al.  Non-invasive positive pressure ventilation to facilitate the post-operative respiratory outcome of spine surgery in neuromuscular children , 2014, European Spine Journal.

[9]  A. Argent,et al.  Mechanical insufflation-exsufflation for people with neuromuscular disorders. , 2013, The Cochrane database of systematic reviews.

[10]  Andrea Aliverti,et al.  Chest wall dynamics during voluntary and induced cough in healthy volunteers , 2012, The Journal of physiology.

[11]  M. Germain,et al.  Performance of the CoughAssist Insufflation-Exsufflation Device in the Presence of an Endotracheal Tube or Tracheostomy Tube: A Bench Study , 2011, Respiratory Care.

[12]  F. Salachas,et al.  A comparison of assisted cough techniques in stable patients with severe respiratory insufficiency due to amyotrophic lateral sclerosis , 2011, Amyotrophic lateral sclerosis : official publication of the World Federation of Neurology Research Group on Motor Neuron Diseases.

[13]  A. Simonds,et al.  The addition of mechanical insufflation/exsufflation shortens airway-clearance sessions in neuromuscular patients with chest infection. , 2009, Respiratory care.

[14]  R. Kravitz.  Airway Clearance in Duchenne Muscular Dystrophy , 2009, Pediatrics.

[15]  W. Kinnear,et al.  Effect of non-invasive ventilation on respiratory muscle loading and endurance in patients with Duchenne muscular dystrophy , 2007, Thorax.

[16]  D. Homnick.  Mechanical insufflation-exsufflation for airway mucus clearance. , 2007, Respiratory care.

[17]  J. Bach,et al.  Effects of Mechanical Insufflation‐Exsufflation on Respiratory Parameters for Patients with Chronic Airway Secretion Encumbrance. , 2004, Chest.

[18]  A. Simonds,et al.  Cough augmentation with mechanical insufflation/exsufflation in patients with neuromuscular weakness , 2003, European Respiratory Journal.

[19]  A Pedotti,et al.  Estimation of end-expiratory lung volume variations by optoelectronic plethysmography , 2001, Critical care medicine.

[20]  I. Smith,et al.  Effect of manually assisted cough and mechanical insufflation on cough flow of normal subjects, patients with chronic obstructive pulmonary disease (COPD), and patients with respiratory muscle weakness , 2001, Thorax.

[21]  J. Bach,et al.  Criteria for extubation and tracheostomy tube removal for patients with ventilatory failure. A different approach to weaning. , 1996, Chest.

[22]  J. Bach.  Mechanical Insufflation-Exsufflation: Comparison of Peak Expiratory Flows With Manually Assisted and Unassisted Coughing Techniques , 1993 .

[23]  A. Clément,et al.  Physiologic benefits of mechanical insufflation-exsufflation in children with neuromuscular diseases. , 2008, Chest.

[24]  A. Pedotti,et al.  Compartmental Analysis of Breathing in the Supine and Prone Positions by Optoelectronic Plethysmography , 2004, Annals of Biomedical Engineering.