Longitudinal assessment of noninvasive positive pressure ventilation adjustments in ALS patients

Journal of the Neurological Sciences
K L GruisE L Feldman

Abstract

The absence of data guiding optimal titration of noninvasive positive pressure ventilation (NIPPV) over time in ALS patients may contribute to the under-prescribing of NIPPV. We conducted a retrospective, single-center, chart review assessment of NIPPV pressure settings used for symptomatic treatment of ALS patients to determine NIPPV adjustments, and to compare survival between those who were tolerant and intolerant to NIPPV. All subjects were started on nocturnal NIPPV at 8 and 3 cm H2O inspiratory and expiratory pressure, respectively. Of the 18 tolerant subjects identified, 4 (22%) had no NIPPV pressure changes before death; 8 (44%), 1 change; 4 (22%), 2 changes; 1 (6%), 3 changes; and 1 (6%), 5 changes. Most pressure changes occurred during the first year of NIPPV initiation. The maximum pressure needed for comfort by any patient in this study was 19/5 cm H2O, while 4 (22%) found the original 8/3 cm H2O settings to be sufficient until death. Subjects in the tolerant group had better survival, when adjusting for age and site of symptom onset (bulbar versus limb), with a hazard ratio of 0.23 [95% confidence interval: 0.10, 0.54]. The current data suggest that ALS patients who are tolerant to NIPPV typically need at least one...Continue Reading

References

Oct 6, 1997·Annals of Internal Medicine·L S AboussouanH Mitsumoto
Jun 29, 1999·Journal of the Neurological Sciences·K A KleopaT Heiman-Patterson
Feb 17, 2001·American Journal of Respiratory and Critical Care Medicine·S Mehta, N S Hill
Jun 14, 2002·Amyotrophic Lateral Sclerosis and Other Motor Neuron Disorders : Official Publication of the World Federation of Neurology, Research Group on Motor Neuron Diseases·Noah LechtzinCharles M Wiener
Aug 10, 2002·Respiration; International Review of Thoracic Diseases·Pinar ErgünCiğdem Biber
Apr 11, 2003·Journal of the Neurological Sciences·Edward Anthony Oppenheimer
Jul 23, 2003·American Journal of Physical Medicine & Rehabilitation·Miriam ButzHerbert Schreiber
Jun 19, 2004·Amyotrophic Lateral Sclerosis and Other Motor Neuron Disorders : Official Publication of the World Federation of Neurology, Research Group on Motor Neuron Diseases·Noah LechtzinUNKNOWN ALS CARE Study Group
Jul 23, 2005·Amyotrophic Lateral Sclerosis and Other Motor Neuron Disorders : Official Publication of the World Federation of Neurology, Research Group on Motor Neuron Diseases·Julia M MorahanRoger Pamphlett
Aug 10, 2005·Seminars in Respiratory and Critical Care Medicine·Nicholas S Hill

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Citations

Nov 1, 2008·European Journal of Neurology : the Official Journal of the European Federation of Neurological Societies·J GilP Couratier
Apr 16, 2013·Journal of Clinical Sleep Medicine : JCSM : Official Publication of the American Academy of Sleep Medicine·Hans D KatzbergYuen T So
Mar 20, 2014·Neurodegenerative Disease Management·Susana Pinto, Mamede de Carvalho
Jul 15, 2015·Sleep Medicine Reviews·Rebekah M AhmedRon R Grunstein
Jul 16, 2008·Physical Medicine and Rehabilitation Clinics of North America·Jeremy M Shefner
Aug 22, 2012·Muscle & Nerve·Kirsten L Gruis, Noah Lechtzin
Jun 18, 2019·Amyotrophic Lateral Sclerosis & Frontotemporal Degeneration·Susan Kathryn BaxterEsther Hobson
Jul 28, 2016·Current Opinion in Neurology·Thanuja DharmadasaMatthew C Kiernan
Jul 6, 2019·The European Respiratory Journal·David O'BrienChristopher McDermott
Sep 12, 2014·Jornal brasileiro de pneumologia : publicaça̋o oficial da Sociedade Brasileira de Pneumologia e Tisilogia·Montserrat Diaz-Abad, John Edward Brown
Feb 1, 2011·Journal of the Neurological Sciences·Paolo VolantiVincenzo La Bella

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