Loutfi Sami Aboussouan, MD; Saeed U. Khan, MD; David P. Meeker, MD; Kay Stelmach, RRT; Hiroshi Mitsumoto, MD
Noninvasive positive-pressure ventilation may benefit patients with amyotrophic lateral sclerosis and respiratory insufficiency.
To determine 1) whether patients tolerant of noninvasive positive-pressure ventilation have better survival than intolerant patients and 2) whether bulbar symptoms account for intolerance of noninvasive positive-pressure ventilation.
Observational cohort study.
Tertiary care referral center.
39 patients with amyotrophic lateral sclerosis who were treated with noninvasive positive-pressure ventilation.
Noninvasive positive-pressure ventilation was started for patients with new orthopnea, new hypercapnia, or both. Patients were divided into two groups: those tolerant of and those intolerant of noninvasive positive-pressure ventilation.
The risk for death from onset of respiratory insufficiency was higher for intolerant patients than for tolerant patients (relative risk, 3.1 [95% CI, 1.8 to 9.6]). Moderate or severe bulbar symptoms were more prevalent among intolerant patients than among tolerant patients (67% compared with 33%; P = 0.04).
Among patients with amyotrophic lateral sclerosis, those who are tolerant of noninvasive positive-pressure ventilation have better survival than do those who are intolerant. Bulbar symptoms partially account for intolerance of noninvasive positive-pressure ventilation.
Aboussouan LS, Khan SU, Meeker DP, Stelmach K, Mitsumoto H. Effect of Noninvasive Positive-Pressure Ventilation on Survival in Amyotrophic Lateral Sclerosis. Ann Intern Med. ;127:450–453. doi: 10.7326/0003-4819-127-6-199709150-00006
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Published: Ann Intern Med. 1997;127(6):450-453.
Neurology, Pulmonary/Critical Care.
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Print ISSN: 0003-4819 | Online ISSN: 1539-3704
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