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An article on the pulmonary considerations related to post polio syndrome.

A postpolio patient may present with classical respiratory problems associated with chronic lung disease, such as productive cough and chronic or recurrent infection. He or she may not be able to cough hard enough to clear phlegm from the chest even during a common cold because of chest and abdominal muscle weakness. The use of a portable positive pressure ventilator by mouth may be helpful for such a patient who can get along under normal conditions but who does not have enough volume to generate an adequate cough during a respiratory infection.

Influenza and pneumococcal vaccination may be particularly important to postpolio patients with respiratory involvement or markedly weak abdominal muscles. Although there is a question about the need for pneumococcal vaccine in immunocompetent persons, many clinicians feel that even if it prevents only a few cases of pneumonia, it is worth trying in view of its safety.

For most polio survivors, a tracheostomy is a frightening final chapter in the polio book. In the very rare instances when one is indicated, specific and thorough counseling should be provided to counter the extreme reaction of fear and anxiety that is possible. Postpolio support groups are an immeasurably valuable source of information and support for these patients.