Good Bronchial Hygiene Reaches the Left Lung: Successful Extubation in a Tetraplegic Patient With Spinal Cord Injury

Ineffective coughing affects bronchial hygiene and is a major contributor to respiratory complications after spinal cord injury (SCI). Mechanical insufflation-exsufflation (MIE) therapy increases inspiratory and expiratory flow to assist bronchial secretions clearance. We present a case of a 67-year-old cervical SCI patient with lung infection and partial atelectasis in the lower left lung, associated with difficult ventilator weaning. About one day after the beginning of MIE therapy, an improvement of the atelectasis was verified. The patient was extubated six days after the beginning of bronchial hygiene with MIE therapy and safely transitioned to non-invasive ventilatory support.