Airway Clearance Management with Vaküm Technology in Subjects with Ineffective Cough: A Pilot Study on the Efficacy, Acceptability Evaluation, and Perception in Children with Cerebral Palsy.

Background
In the medical complexity of a children with cerebral palsy, impaired airway clearance represents a major problem, leading to significative respiratory morbidity and mortality. Its management is difficult because of limited cooperation and poor tolerance to invasive treatments. Free Aspire® (FA) is a device designed to remove bronchial secretions noninvasively, without generating cough.

Methods
The aim of our pilot prospective study is to assess the efficacy and acceptability of FA in removing airway obstruction in subjects with cerebral palsy and ineffective cough. We enrolled 11 subjects. At enrollment and after 3, 6, and 12 months, we collected data regarding health care resources use for respiratory exacerbations, perceived efficacy, and acceptability of treatment.

Results
We observed a reduction in emergency room (ER) accesses, home pharmacological treatment, hospitalizations number, and hospital stay length. In particular after 12 months we observed a reduction of 74% in ER accesses and home pharmacological treatment, 38% in hospitalizations number, and 17% in hospital stay length for respiratory exacerbations. The 100% of caregivers considered the treatment effective and simple to use and noted an improvement in subjects’ general condition. They also reported good treatment tolerance of subjects, with an overall good compliance.

Conclusion
The study demonstrates that FA is an effective device for the removal of bronchial secretions, with a positive caregivers’ perception, that favored a good long-term compliance.