Outcomes and measures in studies of techniques to promote secretion clearance in individuals with neuromuscular conditions: a scoping review.

Background: Techniques to support secretion clearance for individuals with neuromuscular conditions and respiratory muscle weakness include mechanical insufflation-exsufflation and chest wall vibrations. Assessing the comparative efficacy of these techniques is challenging due to the absence of a core outcome set. We sought to describe outcomes and measurement instruments reported in studies of airway clearance techniques for individuals with neuromuscular conditions living in the community.

Evaluation of the Accuracy of a Mechanical Insufflation-Exsufflation Device's Cough Peak Flow Measurement.

Mechanical insufflation-exsufflation (MI-E) is used to augment secretion clearance in neuromuscular patients with weakened cough strength. Cough peak flow (CPF) is a measure of cough function that is used to assess a patient's ability to clear secretions, with thresholds set that categorize cough as effective, ineffective or severely ineffective. MI-E is prescribed according to these thresholds, and CPF is used to assess titration of MI-E settings.

Core Outcome Set for Studies Investigating Secretion Clearance Interventions Used in the Community by Patients With Neuromuscular Disease.

Several treatments are used in the community to improve secretion clearance for patients with neuromuscular disease (NMD). However, the optimal intervention remains unclear with further research required. We aimed to develop a core outcome set (COS) for studies investigating secretion clearance interventions used in the community by patients with NMD.

Mechanical insufflation-exsufflation use in neuromuscular disease: a single centre cohort study.

Introduction: Mechanical insufflation-exsufflation (MIE) is a commonly used therapy to augment secretion clearance in individuals with neuromuscular disease. There are no clear evidence-based guidelines on the settings that should be used in different diagnostic groups and how they should be titrated. We report on the settings used in the largest cohort of individuals using domiciliary MIE in the literature.

Codesign of a Quality Improvement Tool for Adults With Prolonged Critical Illness: A Modified Delphi Consensus Study.

Objectives: Increasing numbers of patients experience a prolonged stay in intensive care. Yet existing quality improvement (QI) tools used to improve safety and standardize care are not designed for their specific needs. This may result in missed opportunities for care and contribute to worse outcomes.

Two-year prospective cohort of intensive care survivors enrolled on a digitally enabled recovery pathway focussed on individualised recovery goal attainment.

Background: Despite substantial evidence documenting physical, psychological, and cognitive problems experienced by intensive care unit (ICU) survivors, few studies explore interventions supporting recovery after hospital discharge. Individualised recovery goal setting, the standard of care across many rehabilitation areas, is rarely used for ICU survivors. Digital health technologies may help to address current service fragmentation and gaps.

Development of a menu of recovery goals to facilitate goal setting after critical illness.

Objective: To develop an expert-informed (including end users) recovery goal menu for adults recovering from critical illness applicable to the community/home setting.

Research Methodology/design: Stage 1 Item generation: iterative development of domains, sub-domains, and goals in consultation with former intensive care patients, family members and expert clinicians. Stage 2 Content validity assessment: cognitive interviews and the content validity index.

Driving resumption after critical illness:A survey and framework analysis of patient experience and process.

Adverse sequelae are common in survivors of critical illness. Physical, psychological and cognitive impairments can affect quality of life for years after the original insult. Driving is an advanced task reliant on complex physical and cognitive functioning.

Informing the standardising of care for prolonged stay patients in the intensive care unit: A scoping review of quality improvement tools.

Objectives: To inform design of quality improvement tools specific to patients with prolonged intensive care unit stay, we determined characteristics (format/content), development, implementation and outcomes of published multi-component quality improvement tools used in the intenisve care unit irrespective of length of stay.

Research Methodology: Scoping review searching electronic databases, trial registries and grey literature (January 2000 to January 2022).

Results: We screened 58,378 citations, identifying 96 studies.

Use of mechanical insufflation exsufflation and manual techniques in an intubated adult with COVID-19 positioned in prone-A case study.

Background And Purpose: The therapeutic benefits of prone positioning have been described over the last 50 years culminating in a systematic review supporting this management strategy for patients with severe hypoxaemic respiratory failure. Early work detailing treatment approaches for COVID-19 have advocated the use of prone positioning. Limited data exists regarding physiotherapy intervention in patients with COVID-19 owing to the recent emergence of this novel disease.

Standardising care in the ICU: a protocol for a scoping review of tools used to improve care delivery.

Background: Increasing numbers of critically ill patients experience a prolonged intensive care unit stay contributing to greater physical and psychological morbidity, strain on families and cost to health systems. Quality improvement tools such as checklists concisely articulate best practices with the aim of improving quality and safety; however, these tools have not been designed for the specific needs of patients with prolonged ICU stay. The primary objective of this review will be to determine the characteristics including format and content of multicomponent tools designed to standardise or improve ICU care.