Case Study: ALS Patient Airway Management with Cough Assist Device
Case Background
A 63-year-old ALS patient in Wuhan experienced airway collapse combined with mucus retention, making conventional bronchoscopy and suction catheter procedures challenging and causing airway mucosal injury and bleeding. Following medical advice, the patient’s family opted for a non-invasive cough assist device for mucus clearance.
Challenges & Solutions
1. Patient Acceptance Challenges
During initial use, the patient resisted: “This feels uncomfortable; I don’t want to continue.”
Engineer’s Response:
Emphasized comparative comfort: “While not entirely comfortable, the cough assist device clears mucus more gently than invasive methods like suction tubes. Remember how the suction tube felt?”
Highlighted non-contact advantage: “This device uses airflow regulation—no invasive tools. Would you try this non-contact method?”
Outcome: Patient agreed after recalling prior negative experiences with traditional methods.
2. Tongue Obstruction
As airflow parameters increased, uncontrolled tongue movements blocked the oral cavity.
Solution:
Deployed an oral support device to maintain airway patency.
Adjusted parameters gradually while monitoring real-time SpO₂ (98-99%) and mucus output.
Result: Improved airway openness and patient cooperation.
3. Parameter Optimization Strategy
Engineers implemented a stepwise parameter adjustment protocol:
Initial Phase: Two low-intensity cycles for tolerance.
Mid-Phase: Optimized parameters for deep mucus clearance.
Final Phase: Personalized settings for three effective clearance cycles.
Critical Note: Post-treatment, the patient reported residual mucus. An additional clearance session achieved complete airway cleansing.
Key Recommendations for ALS Airway Management
Based on this case, QIJIA Medical Team advises:
Prioritize Cough Assist Devices: Non-invasive technology ensures safer, efficient mucus clearance.
Lung Expansion Training: Use the device to improve airway collapse and enhance oxygenation.
Daily Respiratory Muscle Training: Maintain lung function and reduce dependency on invasive interventions.
Conclusion
This case demonstrates how tailored cough assist protocols overcome ALS-specific challenges—psychological resistance, physiological barriers, and complex parameter tuning. The integration of real-time monitoring, oral support tools, and stepwise adjustments ensured effective mucus clearance while minimizing mucosal damage. For ALS patients, adopting cough assist devices not only improves airway management but also enhances long-term quality of life.
Keywords: ALS airway management, cough assist device, non-invasive mucus clearance, respiratory muscle training, QIJIA Medical
: Source: QIJIA Medical Case Study (May 12, 2025)
: Source: Cough Assist Device Clinical Utility (Dec 19, 2024)
: Source: Non-Invasive Cough Assist Device Guidelines (Feb 28, 2025)