Proposals from a French expert panel for respiratory care in ALS patients

Georges, Marjolaine; Pérez, Thierry; Rabec, Claudio; Jacquin, Laurent; Finet-Monnier, A.; Ramos, C.; Patout, Maxime; Attali, Valérie; Amador, Maria del Mar; Gonzalez-Bermejo, Jésus; Salachas, François; Morélot-Panzini, Capucine

doi:10.1016/j.resmer.2022.100901

Cited by 17 publications

(40 citation statements)

References 109 publications

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“…A unique factor in this case report is the pre-existing diagnosis of Bulbar-onset Amyotrophic Lateral Sclerosis. ALS is characterized by the degeneration of upper and lower motor neurons leading to progressive weakness of limbs and the bulbar, thoracic, and abdominal muscles [11]. Onset is divided into three categories, the most common being limb-onset, bulbar-onset, and, rarely, respiratory-onset.…”

Section: Discussionmentioning

confidence: 99%

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Recurrent Lingual Abscess in an Elderly Female With Bulbar Amyotrophic Lateral Sclerosis

Carotenuto¹,

Menke²,

Jolton³

et al. 2022

Cureus

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A lingual abscess is a rare condition that was scarcely described in clinical textbooks. A lingual abscess recurrence is rare and has only been described twice in the literature. Typically, the tongue and oral cavity have multiple intrinsic properties which stave off intralingual infection; however, there may be situations in which these properties are compromised, as demonstrated in oro-motor disability. Lingual abscesses have the potential to develop into catastrophic obstructive airway issues; therefore, early detection and management are paramount. The following is a presentation of an elderly female with Bulbar Amyotrophic Lateral Sclerosis (ALS) treated conservatively for a lingual abscess with recurrence at eleven months posttreatment. Due to her baseline neuromuscular disorder and elevated anesthesia risk, she was treated in the interventional radiology suite with drain placement and Povidone-Iodine sclerotherapy under conscious sedation with excellent results.

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Section: Discussionmentioning

confidence: 99%

“…Bulbar signs and symptoms pose unique management considerations due to the severe limitations on the upper aerodigestive tract, increased risk of aspiration pneumonia, and early ventilator dependence [11][12][13][14]. This significantly affects options for anesthesia.…”

Section: Discussionmentioning

confidence: 99%

Recurrent Lingual Abscess in an Elderly Female With Bulbar Amyotrophic Lateral Sclerosis

Carotenuto¹,

Menke²,

Jolton³

et al. 2022

Cureus

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“…La esclerosis lateral amiotrófica (ELA) es una enfermedad neurodegenerativa, que avanza rápidamente y mortal que ocasiona una debilidad progresiva de la musculatura bulbar, torácica, abdominal y de las extremidades, que da lugar a una incapacidad funcional grave hasta la parálisis completa, siendo las complicaciones respiratorias la causa más frecuente de fallecimiento 1,2 .…”

Section: Editorialunclassified

“…La evaluación precoz y sistemática de la función respiratoria y su monitorización son fundamentales para detectar signos de hipoventilación, de cara a iniciar la ventilación no invasiva (VNI) en el momento adecuado, y anticiparnos a la aparición de un fracaso respiratorio que puede acontecer de forma progresiva o súbita en el seno de un ingreso por la ausencia de reserva funcional [1][2][3] .…”

Section: Editorialunclassified

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La variabilidad asistencial en la ELA: una cuestión pendiente

Blanco¹,

Sayas-Catalán²

2022

RPR

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Pulmonary care for ALS: Progress, gaps, and paths forward

Ackrivo

2023

Muscle and Nerve

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Introduction Adults with amyotrophic lateral sclerosis (ALS) have been using home mechanical ventilation for over 50 years. More recently, home respiratory care has evolved to include portable home ventilators, airway clearance devices, and physiological assessments with telemonitoring capability. Current State of Respiratory Care National organizations currently offer incentives for providing a pulmonary care specialist within a multidisciplinary ALS clinic; however, several critical gaps exist between the available technology and employing a clinician with the necessary expertise. Gaps in Care Lack of formal training and poor financial incentives have led to a paucity of both clinicians and active clinical research engaging in the home respiratory care of ALS. Criteria for noninvasive ventilation (NIV) initiation are controversial, and few guidelines exist on the ideal subsequent adjustments of NIV with evolving disease. Consequently, many patients with ALS tolerate NIV poorly and must face the harrowing decision of hospice vs tracheostomy. Advancement of respiratory care in ALS has been hindered by critical gaps in pulmonologist availability, training in chronic respiratory failure, financial support, clinical research, and clarity on ventilation management beyond initiation. Bringing Respiratory Care Up to Speed Only a multifaceted approach will suffice for addressing the voids in ALS respiratory care, including various education initiatives, financial incentives, clinical research programs, and elevating the standard of respiratory care.

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Proposals from a French expert panel for respiratory care in ALS patients

Cited by 17 publications

References 109 publications

Recurrent Lingual Abscess in an Elderly Female With Bulbar Amyotrophic Lateral Sclerosis

Recurrent Lingual Abscess in an Elderly Female With Bulbar Amyotrophic Lateral Sclerosis

La variabilidad asistencial en la ELA: una cuestión pendiente

Pulmonary care for ALS: Progress, gaps, and paths forward

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