학술논문
Absence of airway secretion accumulation predicts tolerance of noninvasive ventilation in subjects with amyotrophic lateral sclerosis
Document Type
Report
Author
Vandenberghe, Nadia; Vallet, Anne-Evelyne; Petitjean, Thierry; Cam, Pierre Le; Peysson, Stephane; Guerin, Claude; Dailler, Frederic; Jay, Sylvie; Cadiergue, Vincent; Bouhour, Francoise; Court-Fortune, Isabelle; Camdessanche, Jean Philippe; Antoine, Jean-Christophe; Philit, Francois; Beuret, Pascal; Bin-Dorel, Sylvie; Vial, Christophe; Broussolle, Emmanuel
Source
Respiratory Care. September 1, 2013, Vol. 58 Issue 9, p1424, 9 p.
Subject
Language
English
ISSN
0020-1324
Abstract
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. Key words: prognosis; cohort studies; amyotrophic lateral sclerosis; noninvasive ventilation tolerance; airway secretion accumulation; mechanically assisted cough.
Introduction Amyotrophic lateral sclerosis (ALS) is a devastating disease, affecting respiratory muscles and causing breathlessness, morning headaches, unrefreshing sleep, daytime sleepiness, fatigue, impaired concentration, and poor appetite. (1) Respiratory failure [...]
Introduction Amyotrophic lateral sclerosis (ALS) is a devastating disease, affecting respiratory muscles and causing breathlessness, morning headaches, unrefreshing sleep, daytime sleepiness, fatigue, impaired concentration, and poor appetite. (1) Respiratory failure [...]