Systems and methods for adaptive cough detection and adaptive mechanical insufflation-exsufflation (MI-E) therapy

A mechanical ventilation system, comprising:

• a mechanical ventilator configured to deliver ventilation to a patient;
• and
• an electronic controller programmed to control the mechanical ventilator to perform a mechanical insufflation-exsufflation (MI-E) therapy method including performing a MI-E cycle including:
• (i) during an insufflation cycle, delivering pressure to the patient at a positive insufflation gauge pressure;
• (ii) during an exsufflation cycle following step (i), delivering pressure to the patient at a negative exsufflation gauge pressure;
• (iii) determining, based on a presence or absence of a counter pressure spike during the exsufflation cycle, if a zero-flow point during the exsufflation cycle is caused by an active cough or an upper airway collapse;
• and
• (iv) reducing a magnitude of negative exsufflation gauge pressure for a subsequent exsufflation cycle if it is determined in step (iii) that the zero-flow point is caused by an upper airway collapse.