In their 2024 review article Waves of Precision: A Practical Guide for Reviewing New Tools to Evaluate Mechanical In-Exsufflation Efficacy in Neuromuscular Disorders, Chatwin, Sancho, Lujan, Andersen, and Winck present a comprehensive exploration of waveform analysis as an advanced method for assessing and optimizing mechanical insufflation-exsufflation (MI-E) therapy. The authors provide a detailed framework for using pressure, flow, and volume waveforms to understand patient-specific responses, emphasizing the value of real-time waveform interpretation to tailor MI-E settings in neuromuscular disease (NMD) management. Through numerous illustrations and practical examples, the article highlights common and pathological waveform patterns, guiding clinicians in recognizing airway obstructions, leaks, and synchronization issues that may impact secretion clearance.
The authors integrate knowledge from other evaluation techniques—such as auscultation, peak flow measurements, laryngeal diagnostic ultrasound and fiberoptic laryngoscopy—demonstrating how these approaches complement waveform analysis to form a holistic understanding of respiratory function. This review underscores the importance of interpreting waveform morphology not only to adjust MI-E settings but also to enhance patient outcomes through personalized and precise respiratory support. By bridging traditional assessment methods with modern waveform technology, Chatwin et al. contribute a vital resource for clinicians aiming to refine MI-E therapy in clinical practice.
The full article is available here: https://doi.org/10.3390/jcm13092643.
