What is the role of assisted peak cough flows in the treatment of amyotrophic lateral sclerosis (ALS)?

Updated: Jan 02, 2020
  • Author: Divakara Kedlaya, MBBS; Chief Editor: Ryan O Stephenson, DO  more...
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Answer

Answer

As mentioned earlier, assisted peak cough flows should be performed regularly and used to monitor bulbar functioning. Once peak cough flows drop below 160 L/min, flows likely are inadequate to clear debris, thereby resulting in mucous plugging. Risk of mucous plugging is significantly increased during periods of intercurrent respiratory infection and can result in acute respiratory distress necessitating placement of an endotracheal tube. Patients with peak cough flows below this level may require permanent tracheostomy tube placement to allow suctioning and invasive ventilation when needed.


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