International Expert Consensus Study on Mechanical Insufflation-Exsufflation Use in Critically Ill Patients Using Delphi Method

What this Trial Is About

Mechanical insufflation-exsufflation MI-E is a technique that helps clear airways by improving cough performance, mainly used for patients with chronic neuromuscular and respiratory conditions. However, its application in critically ill patients in intensive care units ICUs is inconsistent and lacks standardized guidelines. Current practices vary in patient selection, treatment protocols, and safety management, with limited high-quality evidence to guide clear recommendations. This research conducts an international Delphi consensus study involving expert healthcare professionals to develop standardized guidelines for MI-E use in critically ill patients. The study uses multiple rounds of structured questionnaires to gather and combine expert opinions on indications, contraindications, timing, device settings, safety considerations, and practical barriers related to MI-E therapy in ICUs. Participants, who are clinical experts, will anonymously complete electronic surveys over approximately 12 months. The study analyzes responses using fuzzy logic to reach consensus on best practices for MI-E. The main outcomes include consensus statements on clinical use, safety, and implementation of MI-E in critical care. No patient data are collected, and expert participation is voluntary with confidentiality maintained throughout.

Mechanical Insufflation-Exsufflation in Critically Ill Patients