Amyotrophic lateral sclerosis. Successful treatment of mucous plugging by mechanical insufflation-exsufflation.
Bronchial mucous plugging is the main precipitating factor of acute respiratory failure for patients with neuromuscular disease. Manually assisted coughing and mechanical insufflation-exsufflation can effectively eliminate airway secretions without resorting to tracheal intubation provided that bulbar muscle function is sufficient to permit assisted peak cough flows of 160 l/min or greater. We now report successful use of mechanical insufflation-exsufflation to prevent acute respiratory failure for a patient with amyotrophic lateral sclerosis with no measurable peak cough flow.
Hanayama
K
K
Department of Physical Medicine and Rehabilitation, UMDNJ-New Jersey Medical School, Newark, USA.
Ishikawa
Y
Y
Bach
J R
JR
D000368:Aged; D000690:Amyotrophic Lateral Sclerosis / Q000150:complications*; D003371:Cough; D005260:Female; D006801:Humans; D007327:Insufflation; D007384:Intermittent Positive-Pressure Breathing; D009093:Mucus; D012131:Respiratory Insufficiency / Q000209:etiology* / Q000628:therapy*; D012138:Respiratory Therapy / Q000379:methods*