From bedside to bench - In vivo and in vitro evaluation of mechanically assisted cough treatment in a patient with bulbar Amyotrophic Lateral Sclerosis.
Respir Med Case Rep
; 37: 101649, 2022.
Article
en En
| MEDLINE
| ID: mdl-35480384
ABSTRACT
When the ability to cough is impaired, secretion clearance may be assisted and augmented by Mechanical Insufflation-Exsufflation (MI-E) treatment. In patients with Amyotrophic Lateral Sclerosis, the efficacy of MI-E may be hampered by counterproductive upper airway responses. Careful adjustment of MI-E settings can be beneficial. During the disease progression, a 41-year-old woman with bulbar Amyotrophic Lateral Sclerosis experienced that treatment with MI-E was exhausting and inefficient. Despite adjustments of settings, all treatment led to retching. A change of MI-E device led to more effective treatment. A bench test revealed variations in flow and pressure waveforms in the two devices. When MI-E treatment fails, differences in equipment delivery need to be considered in addition to the adjustment of MI-E settings.
ALS, Amyotrophic Lateral Sclerosis; Amyotrophic lateral sclerosis; Bulbar insufficiency; FlowE-FlowI, Flow bias difference; FlowE: FlowI, Flow bias ratio; MI-E, Mechanical Insufflation-Exsufflation; Mechanical insufflation-exsufflation; Mechanically assisted cough; NT, not tested; PCF, Peak Cough Flow; PEP, Peak Exsufflation pressure; PIP, Peak Insufflation pressure; Rise time; TFL, Transnasal fiberoptic laryngoscopy; Waveforms
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Idioma:
En
Revista:
Respir Med Case Rep
Año:
2022
Tipo del documento:
Article
País de afiliación:
Noruega