A mucus plug is a buildup of mucus in your air passages. It typically takes place during and after surgery since you can’t cough.
Drugs given throughout surgery make you breathe less deeply, so normal secretions gather in the respiratory tracts. Suctioning the lungs throughout surgery helps clear them, however sometimes they still build up. Mucus plugs are likewise common in children, individuals with cystic fibrosis and during extreme asthma attacks.
Lots of things might contribute to mucus plugging in people with ALS. Among them:
- Being sedentary. Lowered motion and lack of exercise causes shallow breathing and reduced airflow from lower airway to upper airway.
- Weak diaphragm and stomach muscles. Failure to broaden the lungs and trigger stomach muscles impairs cough effectiveness.
- Impaired or absent glottic function. If the singing cables suffer due to bulbar muscle weakness or bypassed due to a tracheostomy tube, a person will not have the ability to produce enough thoracic pressure to provide a constant cough.
- Dehydration. Inadequate fluid consumption, by mouth or through a feeding tube, can add to thicker mucus.
- Tracheostomy tube. The existence of an artificial airway can stimulate the lungs to produce more mucus. Also, when a person breathes through a trach tube, it bypasses the nose, whose function is to warm, humidify, and filter inhaled air.
Mucus Plugging Prevention
- Adequate hydration. If an individual breathes with the assistance of a mechanical ventilator and a tracheotomy tube, proper humidity is a lot more crucial. Utilize a heat-and-moisture exchanger (HME or synthetic nose) throughout the day for mobility and a heated humidifier when the individual sleeps during the night.
- Mechanical lung growth and coughing workouts. Incorporate the use of a Cough Assist ® or Vital Cough ® machine at least once or twice a day. They can be used in the automatic mode to deliver a sigh breath on inhalation followed rapidly by a negative pressure breath that can move mucus towards the mouth or trach tube opening. In the manual mode, a person can coordinate with a caregiver to take a series of smaller stacked breaths to broaden the lungs followed by a separate set of smaller sized mechanical coughs. Some people find this next strategy more comfy and efficient. Mechanical lung growth and coughing devices can, and should, be used with a tracheostomy tube.
- Manually assisted cough (abdominal thrusts or seated Heimlich). This low-tech maneuver can be utilized along with mechanical coughs or independently. Method: Be in a somewhat reclined position. Have the caregiver place both turn over the person’s abdomen just below the navel in a “V” shape. Use the fat pad below the thumb as it is softer. Coordinate with one another, so the individual with ALS is making a coughing effort while the caregiver is delivering a series of quick and powerful thrusts.
- A portable suction system ought to be readily available to catch any mucus that has been moved into the trach tube or back of the throat.
- Manual sigh or stacked breaths can be delivered using a self-inflating manual ventilation bag (“Ambu” bag). Manual strategies with a bag and stomach thrusts can be quickly used anywhere if a person feels they are choking on a mucus plug.