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Expiratory muscle weakness and assisted cough in ALS
Heinz Lahrmann1, Monika Wild, Franz Zdrahal
1Neurological Department, Kaiser Franz Josef Hospital and Ludwig Boltzmann Institute for NeuroOncology, Vienna, Austria. heinz.lahrmann@kfj.magwien.gv.at
Abstract:
Elimination of airway secretion is a major issue in the care of patients with ALS. Sufficient cough flows have to be generated by expiratory muscles to allow airway clearance. Bulbar and expiratory muscle weakness are often reasons for failure of non-invasive ventilation (NIV) and may lead to tracheostomy. Expiratory aids may help to overcome these problems, at least for some time. We report a patient with advanced ALS, receiving nocturnal NIV, who gained much benefit from regular use of a mechanical in-exsufflation device.