Predictors of non-invasive ventilation tolerance in amyotrophic lateral sclerosis

Volanti, Paolo; Cibella, Fabio; Sarvà, M. C.; Cicco, D. De; Spanevello, Antonio; Mora, Gabriele; Bella, Vincenzo La

doi:10.1016/j.jns.2010.12.021

Cited by 44 publications

(26 citation statements)

References 28 publications

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“…[3][4][5][6]18 Although Aboussouan et al 3 found that NIV tolerance in subjects with ALS was higher with PC-CMV, the findings of the present study, using only VC-CMV NIV, show a rate of tolerance of 92%, similar to the best results in the literature. In previous studies focusing on a heterogeneous population including neuromuscular subjects, VC-CMV NIV was associated with more gastrointestinal adverse effects, 19,20 mainly flatulence, although no differences between the 2 ventilator modes in overall acceptability have been reported.…”

Section: Discussionsupporting

confidence: 83%

Tolerance of Volume Control Noninvasive Ventilation in Subjects With Amyotrophic Lateral Sclerosis

et al. 2015

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BACKGROUND: Noninvasive ventilation (NIV) tolerance has been identified as an independent predictor of survival in amyotrophic lateral sclerosis (ALS). Volume control continuous mandatory ventilation (VC-CMV) NIV has been associated with poor tolerance. The aim of this study was to determine the tolerance of subjects with ALS to VC-CMV NIV. METHODS: This was a prospective study involving subjects with ALS who were treated with VC-CMV NIV. Respiratory and functional parameters were recorded when the subjects began ventilatory support. NIV tolerance was evaluated after 3 months. RESULTS: Eighty-seven subjects with ALS were included. After 3 months, 80 subjects (92%) remained tolerant of NIV. Tolerant subjects presented greater survival (median 22.0 months, 95% CI 14.78 -29.21) than intolerant subjects (median 6.0 months, 95% CI 0.86 -11.13) (P ‫؍‬ .03). The variables that best predicted NIV tolerance were mechanically assisted cough peak flow (P ‫؍‬ .01) and percentage of time spent with S pO 2 < 90% at night while on NIV (P ‫؍‬ .03) CONCLUSIONS: VC-CMV NIV provides high rates of NIV tolerance in subjects with ALS. Mechanically assisted cough peak flow and percentage of time spent with S pO 2 < 90% at night while using NIV are the 2 factors associated with tolerance of VC-CMV NIV in subjects with ALS.

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Section: Discussionsupporting

confidence: 83%

Tolerance of Volume Control Noninvasive Ventilation in Subjects With Amyotrophic Lateral Sclerosis

et al. 2015

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“…Seated erect Forced Vital Capacity (FVC), nocturnal oxymetry and blood gas analysis were used as indexes of respiratory function, whereas the severity of dysphagia was evaluated through the one-hundred milliliter water swallow test [3]. When necessary, a PEG device was placed and/or a NIV was initiated [3,23], according to standard management procedures [24]. Disease progression was evaluated through two clinimetric rating scales: i) the Appel ALS Rating Scale (AARS) and ii) the revised ALS functional rating scale (ALSFRS-R) [19,20].…”

Section: Methodsmentioning

confidence: 99%

Tracheostomy mechanical ventilation in patients with amyotrophic lateral sclerosis: Clinical features and survival analysis

Spataro

Bono

Marchese

et al. 2012

Journal of the Neurological Sciences

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TMV is increasingly performed in ALS patients. Nearly all TMV patients live at home and most of them are fed through a PEG device. Survival after tracheostomy is generally increased, with the stronger effect in patients younger than 60. This survival advantage is apparently lost when TMV is performed in patients older than 60. The results of this study might be useful for the decision-making process of patients and their families about this advanced palliative care.

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“…When the subscore was 8/8, the subject was classified as having non-bulbar ALS or the pure spinal form at NIV initiation. 15,19,20 We also used the saliva subcomponent of the ALSFRS-R (with a total score of 12) and decided arbitrarily and a priori that a score of Յ 9/12 corresponded to bulbar form at NIV initiation. Respiratory status was assessed from dyssomnia, paradoxical breathing, and pulmonary function test results.…”

Section: Clinical Datamentioning

confidence: 99%

Absence of Airway Secretion Accumulation Predicts Tolerance of Noninvasive Ventilation in Subjects With Amyotrophic Lateral Sclerosis

et al. 2013

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OBJECTIVE: To assess factors that predict good tolerance of noninvasive ventilation (NIV), in order to improve survival and quality of life in subjects with amyotrophic lateral sclerosis. METHODS: We conducted a prospective study in subjects with amyotrophic lateral sclerosis and requiring NIV. The primary end point was NIV tolerance at 1 month. Subjects, several of whom failed to complete the study, were classified as "tolerant" or "poorly tolerant," according to the number of hours of NIV use (more or less than 4 h per night, respectively). RESULTS: Eighty-one subjects, 73 of whom also attended the 1-month follow-up visit, participated over 34 months. NIV tolerance after the first day of utilization predicted tolerance at 1 month (77.6% and 75.3% of subjects, respectively). Multivariate analysis disclosed 3 factors predicting good NIV tolerance: absence of airway secretions accumulation prior to NIV onset (odds ratio 11.5); normal bulbar function at initiation of NIV (odds ratio 8.5); and older age (weakly significant, odds ratio 1.1). CONCLUSION: Our study reveals 3 factors that are predictive of good NIV tolerance, in particular the absence of airway secretion accumulation, which should prompt NIV initiation before its appearance.

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Predictors of non-invasive ventilation tolerance in amyotrophic lateral sclerosis

Cited by 44 publications

References 28 publications

Tolerance of Volume Control Noninvasive Ventilation in Subjects With Amyotrophic Lateral Sclerosis

Tolerance of Volume Control Noninvasive Ventilation in Subjects With Amyotrophic Lateral Sclerosis

Tracheostomy mechanical ventilation in patients with amyotrophic lateral sclerosis: Clinical features and survival analysis

Absence of Airway Secretion Accumulation Predicts Tolerance of Noninvasive Ventilation in Subjects With Amyotrophic Lateral Sclerosis

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