Is chronic ventilatory support really effective in patients with amyotrophic lateral sclerosis

article




Hazenberg, A.

Kerstjens, H.A.M.

Prins, S.C.L.

Vermeulen, K.M.

Wijkstra, P.J.
Most patients with amyotrophic lateral sclerosis (ALS) develop respiratory insufficiency in the advanced stage of their disease. Non-invasive ventilation (NIV) is commonly regarded to be a treatment that is effective in reducing these complaints. To assess whether the effect of NIV on gas exchange and quality of life (QOL) is different in patients with ALS versus without ALS. A post hoc analysis was done with data from a previously published trial, in which all patients were instituted on NIV. Arterial blood gasses were assessed next to QOL by generic as well as disease-specific questionnaires. 77 patients started NIV: 30 with ALS and 47 without. Both groups showed significant improvements in blood gasses after 2 and 6 months. Compared to the non-ALS group, the ALS group had significantly worse scores after 6 months in MRF-28, SRI, HADS and SF-36 than the non-ALS group. This study shows that NIV improves gas exchange, both in patients with and without ALS. QOL improves markedly more in patients without ALS than in those with ALS, in whom only some domains improve. Our observation of little or no effect in ALS patients warrants a large study limited to ALS patients only. © 2016, The Author(s).
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Amyotrophic lateral sclerosisNon-invasive ventilationQuality of lifeadultamyotrophic lateral sclerosisarterial carbon dioxide tensionArticleblood oxygen tensioncontrolled studyfemaleforced expiratory volumeforced vital capacityHospital Anxiety and Depression Scalehumanlung gas exchangemajor clinical studymaleMaugeri respiratory failure 28noninvasive ventilationpriority journalquality of lifequestionnairerandomized controlled trialShort Form 36agedamyotrophic lateral sclerosisbibliographic databaseblood gas analysiscomplicationmiddle agedprocedurespsychologyrandomized controlled trial (topic)Respiratory Insufficiencyseverity of illness indexstatistics and numerical datatreatment outcomeAdultAgedAmyotrophic Lateral SclerosisBlood Gas AnalysisDatabases, BibliographicFemaleHumansMaleMiddle AgedNoninvasive VentilationQuality of LifeRandomized Controlled Trials as TopicRespiratory InsufficiencySeverity of Illness IndexTreatment Outcome
TNO Identifier
954705
Repository link
https://resolver.tno.nl/uuid:dde319af-714a-4793-ae46-9569c60d4f00
ISSN
03405354
Source
Journal of Neurology, 263(12), pp. 2456-2461.
Pages
2456-2461
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