Amyotrophic lateral sclerosis. Successful treatment of mucous plugging by mechanical insufflation-exsufflation

Am J Phys Med Rehabil. 1997 Jul-Aug;76(4):338-9. doi: 10.1097/00002060-199707000-00017.


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.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Amyotrophic Lateral Sclerosis / complications*
  • Cough
  • Female
  • Humans
  • Insufflation*
  • Intermittent Positive-Pressure Breathing
  • Mucus*
  • Respiratory Insufficiency / etiology*
  • Respiratory Insufficiency / therapy*
  • Respiratory Therapy / methods*