Skip Navigation
Menu
Letters |1 April 1998

Positive-Pressure Ventilation in Amyotrophic Lateral Sclerosis

Loutfi S. Aboussouan, MD; Saeed U. Khan, MD; Hiroshi Mitsumoto, MD

Article, Author, and Disclosure Information
Author, Article, and Disclosure Information
  • Wayne State University School of Medicine; Detroit, MI 48201 Cleveland Clinic Foundation; Cleveland, OH 44195
×
FULL TEXT
IN RESPONSE:
We agree that noninvasive positive-pressure ventilation should not be restricted to nighttime. Although we emphasized nocturnal use, we also encouraged daytime use. However, tolerance of this treatment was strictly defined as the ability to sleep nightly for at least 4 consecutive hours with the device, regardless of daytime use. We did use other interfaces, including mouth pieces for daytime ventilation. Every attempt was made to control mucus plugging and secretions by using suction devices, medications, and assisted coughing. Mechanical insufflation-exsufflation was used, but only when it became available at the end of our study.
In that context, our results may not actually differ much from Bio and Bach's experience. Our patients tolerant of noninvasive positive-pressure ventilation did not survive only 15 months. Rather, the median survival was 15 months; as our figures indicate, more than 40% of tolerant patients remain alive 2 years after initiation of noninvasive positive-pressure ventilation. We now have 10 patients with amyotrophic lateral sclerosis, including one third (6 of 18) of the tolerant patients of our original cohort, who have progressively increased the time they spend on noninvasive positive-pressure ventilation to 24 hours a day, with only one hospitalization for deep venous thrombosis. Two patients have been successfully maintained on 24 hours of ventilation per day for more than 3 years.
FULL TEXT
PDF
Not Available
Citations
Citation

Aboussouan LS, Khan SU, Mitsumoto H. Positive-Pressure Ventilation in Amyotrophic Lateral Sclerosis. Ann Intern Med. ;128:602. doi: 10.7326/0003-4819-128-7-199804010-00026

Download citation file:

© 2019

×
Permissions

Published: Ann Intern Med. 1998;128(7):602.

DOI: 10.7326/0003-4819-128-7-199804010-00026

0 Citations
CONTINUE WITH LIMITED ACCESS
Annals of Internal Medicine
To receive access to the full text of freely available articles, alerts, and more. You will be directed to acponline.org to complete your registration.
×
acp link acp
silverchair link silverchair

Copyright © 2019 American College of Physicians. All Rights Reserved.

Print ISSN: 0003-4819 | Online ISSN: 1539-3704

Privacy Policy

|

Conditions of Use

This site uses cookies. By continuing to use our website, you are agreeing to our privacy policy. | Accept
×

You need a subscription to this content to use this feature.

×
PDF Downloads Require Access to the Full Article.
Annals of Internal Medicine
To receive access to the full text of freely available articles, alerts, and more. You will be directed to acponline.org to complete your registration.
×
Access to this Free Content Requires Users to be Registered and Logged In. Please Choose One of the Following Options
Annals of Internal Medicine
To receive access to the full text of freely available articles, alerts, and more. You will be directed to acponline.org to complete your registration.
×