ALS Overview

By SWA

Managing Phlegm in ALS: Effective Treatments and Techniques

Amyotrophic Lateral Sclerosis (ALS) not only impairs muscle function but also affects the respiratory system, leading to difficulties in clearing phlegm. Effective management of phlegm is crucial for maintaining airway patency and preventing respiratory complications. This article explores various strategies and treatments to help individuals with ALS manage phlegm, including the use of specialized devices like the Cough Assist® or Vital Cough® machines

Triggers and Risk Factors for ALS

Genetic Factors

ALS has strong genetic components, with over 40 genes implicated in its development. Some of the most commonly affected genes include:

  • C9orf72
  • SOD1
  • TARDBP
  • FUS

Understanding Phlegm Management in ALS

People with ALS often experience difficulty in clearing phlegm due to weakened respiratory muscles. Accumulation of mucus can lead to respiratory infections and further complications. Effective phlegm management involves both non-invasive techniques and mechanical aids.

Mechanical Aids: Cough Assist® and Vital Cough® Machines

The Cough Assist® and Vital Cough® machines are mechanical devices designed to help patients with ALS clear mucus from their airways. These devices simulate a natural cough by delivering a series of inhalations followed by exhalations at a controlled pressure. Here’s how they work:

  1. Automatic Mode: These machines can be set to automatic mode, where they deliver a deep breath (sigh breath) on inhalation.
  2. Rapid Exhalation: This is followed by a rapid shift to negative pressure, creating a cough-like exhalation that helps move mucus towards the mouth or trach tube opening.
  3. Frequency: It is recommended to use these devices at least once or twice a day to maintain clear airways.

Additional Techniques for Phlegm Management

In addition to using mechanical aids, several other techniques can help manage phlegm in ALS patients:

1. Hydration

  • Importance: Staying well-hydrated helps thin the mucus, making it easier to expel.
  • Methods: Encourage frequent sips of water, use of humidifiers, and consumption of fluids like soups and broths.

2. Chest Physiotherapy

  • Techniques: This includes manual chest percussion, vibration, and postural drainage. These techniques help loosen and mobilize mucus from the lungs.
  • Professional Assistance: A respiratory therapist can perform these techniques or teach caregivers how to do them effectively.

3. Suction Devices

  • Use: For patients with significant difficulty clearing mucus, portable suction devices can be used to physically remove mucus from the throat.
  • Procedure: These devices can be inserted into the throat or trach tube to suction out mucus directly.

4. Medications

  • Mucolytics: Medications like acetylcysteine can help thin mucus, making it easier to expel.
  • Bronchodilators: These can help open airways, facilitating easier breathing and mucus clearance.

5. Positioning

  • Technique: Sitting up or lying in a semi-reclined position can help prevent mucus from pooling in the lungs.
  • Rotation: Regularly changing positions can also aid in mucus movement and prevent pressure sores.

Conclusion

Effective phlegm management in ALS is crucial to prevent respiratory complications and maintain quality of life. Using devices like the Cough Assist® or Vital Cough® machines, along with additional techniques like hydration, chest physiotherapy, suction devices, medications, and proper positioning, can significantly help in managing mucus clearance. Regular use of these interventions can aid in maintaining airway patency and reducing the risk of infections.

For more information and resources on managing ALS, visit the following links:

References

  1. ALS Association. (n.d.). Respiratory Care in ALS. Retrieved from https://www.als.org/navigating-als/living-with-als/respiratory-care
  2. National Institute of Neurological Disorders and Stroke. (n.d.). Amyotrophic Lateral Sclerosis (ALS) Fact Sheet. Retrieved from https://www.ninds.nih.gov/disorders/patient-caregiver-education/fact-sheets/amyotrophic-lateral-sclerosis-als-fact-sheet
  3. Mayo Clinic. (n.d.). Amyotrophic Lateral Sclerosis (ALS). Retrieved from https://www.mayoclinic.org/diseases-conditions/amyotrophic-lateral-sclerosis/symptoms-causes/syc-20354022

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