1.4 Contraindications

Absolute contraindications to the use of SIMEOX are:

SIMEOX cannot be used in patients with:

Inability to cough forcefully and independently

Neuromuscular disease with respiratory muscle

weakness

An active requirement for assistance with

inspiration (e.g., ventilatory assistance with

endotracheal tube, tracheostomy tube, or

ventilated with a mask)

The relative contraindications to its use are as follows:

Unstable cardiovascular pathologies (recent

heart attack, unstable angina, uncontrolled

arrhythmias, unstable heart failure)

Hemodynamic Instability

Acute pneumothorax or susceptibility to

pneumothorax or pneumo-mediastinum

Active or recent gross hemoptysis

Recent cardiothoracic surgery, including

esophageal surgery

Severe acute lung injury

Inspiratory muscle weakness with inability to

tolerate increased work of breathing

Oropharyngeal and/or oral muscle weakness

Severe restrictive disease (Total Lung Capacity

< 60%)

Airway at risk for aspiration such as recent tube

feeding or meal

Uncontrolled gastroesophageal reflux disease

(GERD)

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