Pulmonary evaluation and prevalence of non-invasive ventilation in patients with amyotrophic lateral sclerosis: a multicenter survey and proposal of a pulmonary protocol

Melo, Jairo; Homma, Arturo; Iturriaga, Erin; Frierson, Lisa; Amato, AA; Anzueto, Antonio; Jackson, Carlayne E.

doi:10.1016/s0022-510x(99)00228-2

Cited by 73 publications

(43 citation statements)

References 9 publications

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“…FVC is the most commonly used respiratory measurement in ALS, 34 and it was a significant predictor of survival (Class III). 35 FVC may be insensitive since 13/20 patients with an FVC Ͼ70% had abnormal maximal inspiratory pressure (MIP) ϽϪ60 cm (Class III).…”

Section: Discussionmentioning

confidence: 99%

Practice Parameter update: The care of the patient with amyotrophic lateral sclerosis: Drug, nutritional, and respiratory therapies (an evidence-based review)

et al. 2009

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Section: Discussionmentioning

confidence: 99%

Practice Parameter update: The care of the patient with amyotrophic lateral sclerosis: Drug, nutritional, and respiratory therapies (an evidence-based review)

et al. 2009

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“…Melo et al 23 reported that severity of dyspnea was related to respiratory muscle weakness expressed as abnormal MIP and MEP. Similarly, Dugan et al 24 found reduced values of MIP and MEP in dyspneic ALS patients.…”

Section: Discussionmentioning

confidence: 99%

Amyotrophic lateral sclerosis: combined nutritional, respiratory and functional assessment

Silva

Mourão

Silva

et al. 2008

Arq. Neuro-Psiquiatr.

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-Objective:To establish correlations between nutritional, functional and respiratory indices of patients with amyotrophic lateral sclerosis (ALS). Method: Twenty patients (13 appendicular -GA and 7 bulbar -GB) were included in the multidisciplinary study at the Neurological Clinic Ambulatory of the University of Campinas Hospital. Results: Among the GA type significant correlation was observed between maximal inspiratory (MIP) and expiratory (MEP) pressure (r= -0.76), MEP and pulse oxymetry (r=0.58), MIP and percent weight loss (%WL; r=0.59), and between MIP, total and subscale respiratory scores (ALSFRS-R) with %WL. With regard to the GB, correlation was found between MEP and body mass index (BMI) (r=0.97). In both GA and GB correlations were noticed between the BMI and the variables mass (kg), fat (%), arm and wrist circumference (cm), and tricipital, subscapular and supra-iliac skinfolds (mm), as well as the arm muscle circumference (cm) and fatty arm muscular area (mm 2 ). Conclusion: It is suggested that the application of simple anthropometric measurements could be useful in routine monitoring of patients with ALS.KEY WORDS: amyotrophic lateral sclerosis, nutritional support, respiratory tests, ALSFRS scale. esclerose lateral amiotrófica: correlações dos indicadores da avaliação nutricional, funcional e respiratóriaResumo -Objetivo: Correlacionar os indicadores utilizados na avaliação nutricional, funcional e respiratória de indivíduos com esclerose lateral amiotrófica (ELA). Método: Vinte pacientes (13 apendiculares -GA e 7 bulbares -GB) foram incluídos no estudo usando parâmetros nutricionais, respiratórios e escala funcional (ALSFRS-R). Resultados: Entre os pacientes do GA, as correlações observadas foram: pressão inspiratória máxima (PI max ) e expiratória máxima (PE max ) (r= -0,76); PE max e oximetria de pulso (r=0,58); PI max e porcentagem de perda de peso (%PP) (r=0,59); e entre PI max , escore ALSFRS-R com %PP. No GB, houve correlação entre MEP e índice de massa corporal (IMC) (r=0,97). Em GA e GB, observaram-se correlação entre IMC e as variáveis: massa, gordura (%), circunferência braquial e punho, pregas cutâneas tricipital, subescapular e supra-ilíaca, circunferência muscular do braço (cm), área muscular gordurosa do braço (mm 2 ). Conclusão: Sugere-se a aplicação deste conjunto de medidas durante a evolução clínica de indivíduos com ELA. PALAVRAS-CHAVE: esclerose lateral amiotrófica, suporte nutricional, testes respiratórios, escala ALSFRS-R.

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“…In contract, all patients in the BO group were treated with NIV after dysphagia onset. In the present study, all patients were offered NIV when their FVC drops below 50% or patients had clinical findings of hypoventilation (Melo et al 1999, Kleopa et al 1999. If NIV was not tolerated, patients were immediately switched to TIV (NIV, 28 patients; TIV, 2 patients).…”

Section: Factors That Affect the Progression Of Dysphagiamentioning

confidence: 99%

The variety of dysphagia progression in amyotrophic lateral sclerosis (ALS)

Shoji

Nakane

Mikushi

et al. 2015

MRAJ

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Amyotrophic lateral sclerosis (ALS) is a neurodegenerative disease characterized by onset within the upper limb, lower limb, or bulbar musculature. Regardless of site of onset, dysphagia inevitably occurs. This study aimed to examine the course of dysphagia in ALS, and to investigate whether the progression of dysphagia differs by site of onset. Thirty ALS patients were included. For each patient, we collected information on site of disease onset (bulbar or limb onset), duration to initiation of gastrostomy feeding from disease onset, dysphagia onset, course of dysphagia, and course of the respiratory function after dysphagia onset. Patients were divided into two groups based on the site of onset: the bulbar onset group (the BO group, i.e., clinical onset was characterized by dysarthria and/or dysphagia) and the limb onset group (the LO group, i.e., limb weakness was the first symptom). Each survey item was compared between two groups. There were no significant differences in time to initiation of gastrostomy feeding from disease onset between groups (p=0.45). On the other hand, there were significant differences in dysphagia onset, course of dysphagia, and course of the respiratory function after dysphagia onset (p=0.0008, p=0.007, p=0.0002, respectively).Our result suggest that the progression of dysphagia in ALS may differ by site of onset. Compared with bulbar onset ALS patients, progression of dysphagia may be faster in limb onset patients. Moreover, the decline in respiratory function is likely to influence the progression of dysphagia.

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Pulmonary evaluation and prevalence of non-invasive ventilation in patients with amyotrophic lateral sclerosis: a multicenter survey and proposal of a pulmonary protocol

Cited by 73 publications

References 9 publications

Practice Parameter update: The care of the patient with amyotrophic lateral sclerosis: Drug, nutritional, and respiratory therapies (an evidence-based review)

Practice Parameter update: The care of the patient with amyotrophic lateral sclerosis: Drug, nutritional, and respiratory therapies (an evidence-based review)

Amyotrophic lateral sclerosis: combined nutritional, respiratory and functional assessment

The variety of dysphagia progression in amyotrophic lateral sclerosis (ALS)

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