Early use of non invasive ventilation in patients with amyotrophic lateral sclerosis: what benefits?

C. Terzano, S. Romani

Respiratory Diseases and ALS Respiratory and Critical Care Unit, School of Specialization in Respiratory Diseases, “Sapienza” University of Rome, Rome, Italy. cterzano@tin.it

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• Respiratory Medicine

OBJECTIVE: The aim of this study was to analyze the efficacy of an early start of NIV in ALS patients, evaluating respiratory and ventilatory parameters.

PATIENTS AND METHODS: Functional respiratory parameters and arterial blood gas analysis were evaluated in forty-six patients. All patients were informed about the benefits and possible adverse effects of therapeutic support with NIV and divided in two groups based on the compliance to early start therapy with NIV (Group A) or not (Group B).

RESULTS: Among 46 ALS patients consecutively visited in our Unit, we included 20 patients in the Group A and 16 in the Group B. We have emphasized the importance of the early use of NIV stressing the difference between two groups analyzed, particularly in terms of pulmonary function tests and arterial blood gas analysis. Significant correlation was observed between Vital Capacity (VC), Forced Expiratory volume in one second (FEV1), and maximal inspiratory pressures (PImax).

CONCLUSIONS: Our study highlights the importance of noninvasive mechanical ventilation as a treatment for ALS patients and also shows the early start of NIV as an important approach in order to postpone the functional decline and the decrease of respiratory muscle strength.

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