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Abstract Details

Feasibility and safety of the Metaneb® System in neurocritical care patients
Neuro Trauma and Critical Care
P12 - Poster Session 12 (5:30 PM-6:30 PM)

Critically ill patients are at increased risk of morbidity and mortality due to severe organ dysfunction. Pulmonary dysfunction is among the most common non-neurologic complication in patients with acute neurological injury due to respiratory muscle weakness, depressed central respiratory drive, or impaired pharyngeal function. To date, there has been a minimal emphasis in the literature on preventive pulmonary care in patients with neurological illnesses despite the high prevalence of respiratory complications. This study aims to assess the use of the Metaneb system, a medical device designed to decrease atelectasis and improve airway clearance, in acute neurologically injured patients by analyzing its feasibility and safety. 

To evaluate the feasibility and safety of the Metaneb® system in patients in the neurocritical care unit (NCU).
We performed a retrospective, single-center study of patients >18 years of age admitted to the NCU for acute neurological injury and received at least one Metaneb® therapy between August 2016 and August 2018.

The primary outcome measure was all-cause discontinuation of Metaneb therapy. Secondary measures included indications for therapy and safety related measures. Forty-one patients met the inclusion criteria. Median age was 63 years (IQR: 45.5 - 69.5 years), 63.4% (n = 26) were women and 80.5% (n = 33) were Caucasian. The most common indications forMetaneb therapy were for airway clearance (70.7%; n = 29) and pulmonary hygiene (68.3%; n = 28). Median treatment days was 4 (IQR: 2 - 5.5) with a median of 2 treatments (IQR: 1- 3).  Discontinuation for clinical improvement occurred in 75.6% (n = 31). The most common safety cause for discontinuation was due to respiratory therapist being called away (15%; n = 6).

Metaneb is feasible and may be safe to use in neurocritical care patients. A prospective, randomized-controlled trial is necessary to evaluate the efficacy of this potentially prophylactic and therapeutic modality. 

Evien Albazi
Mrs. Albazi has nothing to disclose.
Azam Tolla, DO Dr. Tolla has nothing to disclose.
No disclosure on file
Tracy J. Koehler Tracy J. Koehler has nothing to disclose.
No disclosure on file
No disclosure on file
Brandon Francis, MD Dr. Francis has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Sunovian. Dr. Francis has received personal compensation in the range of $500-$4,999 for serving as an Expert Witness for Montgomery and Associates.