What is maximum insufflation capacity (MIC)?

Please use this forum for any general discussions or questions you have about noninvasive ventilatory support and mechanical insufflation-exsufflation (MIE).
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curiousgeorge
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What is maximum insufflation capacity (MIC)?

Postby curiousgeorge » Wed Mar 30, 2016 1:47 pm

What is maximum insufflation capacity (MIC)?

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Re: What is maximum insufflation capacity (MIC)?

Postby lousaporito » Wed Mar 30, 2016 5:35 pm

Maximum insufflation capacity (MIC) is the maximum volume of air that the glottis can hold after air stacking. It is commonly performed by using an ambu bag to deliver a maximum volume of air above a patient’s vital capacity. Then, the volume is measured with a spirometer. Routine MIC measurements are important to assess lung compliance and should measured at each visit. Improved lung compliance results in better air delivery via portable ventilator and reduced leakage from oral and nasal interfaces. It also improves coughassist efficacy.

To improve MIC, patients should air stack 3 times a day (10-15 cycles per session). If unable to coordinate stacked breaths from a ventilation device (ambu bag or portable ventilator), an alternative method of lung expansion is to use the coughassist at 50-60 cm H2O.
Lou Saporito, BA, RRT
Technical Director, VentilaMed BreatheNVS
Technical Director, Center for Ventilator Management Alternatives

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Re: What is maximum insufflation capacity (MIC)?

Postby cpickford47 » Mon Jun 06, 2016 8:49 pm

1) I have never had a measurement of MIC at an office visit. How is it best to start that conversation with a physician? Is the MIC something I need to have included in pulmonary function testing?

2)I almost pass out if I use the ventilator to air stack. With the exhalation support of the Cough Assist, I do just fine. Why is there a difference in my response to the Cough Assist and the ventilator (Trilogy)?

3) Should MIC be one of the standard measures used to describe my lung health and function?

cpickford47

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lousaporito
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Re: What is maximum insufflation capacity (MIC)?

Postby lousaporito » Tue Jun 07, 2016 9:04 am

Start the conversation by showing your dr the conversation here but don't be surprised if met with skepticism or complete opposition especially if they're a Pulmonary Dr since they've been trained to a a avoid high airway pressures which can damage diseased lungs. You need to point out that you don't have lung disease, you just can't take deep breaths due to your Neuro-muscular condition and this results in stiff, under expanded and partly collapsed lungs. Measurement of MIC is virtually unknown to most physicians so you should visit one of the the recommended centers listed on BreatheNVS which only need to be done once a year. As far as feeling faint during air stacking, it is rare but if your blood pressure is on the low side, putting air pressure into the lung can reduce blood flow back to the heart and can cause a temporary drop in blood pressure causing light headedness, using the Cough Assist with the negative pressure on actually increases blood flow back to the heart so probably eliminates the blood pressure drop. Either method will provide adequate lung expansion.
Lou Saporito RRT
Lou Saporito, BA, RRT
Technical Director, VentilaMed BreatheNVS
Technical Director, Center for Ventilator Management Alternatives

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Re: What is maximum insufflation capacity (MIC)?

Postby Debcarp » Tue Aug 23, 2016 2:04 pm

Hi, would this insufflation method help COPD ? My husbands lung is shrinking plus the airwaves within it are narrowing ?

Thanks , Deborah Carpenter

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Re: What is maximum insufflation capacity (MIC)?

Postby bachjr » Sat Aug 27, 2016 7:33 pm

Generally not. It is only a substitute for muscle weakness.
John R. Bach MD
Medical Director, VentilaMed BreatheNVS
Medical Director, Center for Ventilator Management Alternatives
Professor of Physical Medicine and Rehabilitation, Professor of Neurology, Rutgers New Jersey Medical School


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