Despite its potential benefits, it is unclear how professionals use mechanical insufflation-exsufflation (MI-E) in Brazilian intensive care units (ICUs). This survey aimed to describe MI-E use among health care professionals registered with the Brazilian Association of Intensive Care. Cross-sectional electronic survey of health care professionals (physicians, physiotherapists and nurses) registered with the Brazilian Association of Intensive Care. A total of 232 surveys were returned. An MI-E device was available in 20.9% of ICUs. Even in these ICUs, the use of MI-E was infrequent (daily, 12.9%
weekly, 22.6%
monthly or less, 64.5%). Lack of knowledge, inadequate resources and lack of scientific evidence were reported as barriers to the regular use of MI-E. MI-E was not widely adopted in Brazilian ICUs, and the range of reported barriers warrants further investigation. Results of this study highlighted the low utilization of MI-E by health care professionals, including nurses, working in ICUs in Brazil. Lack of knowledge and supportive scientific evidence were identified as significant barriers to implementation and use. These barriers can be addressed through controlled clinical trials and team training.