Predictors of Need for Noninvasive Ventilation During Respiratory Tract Infections in Medically Stable, Non-Ventilated Subjects With Amyotrophic Lateral Sclerosis.

BACKGROUND: Acute lower respiratory infections can impair muscle strength in patients with amyotrophic lateral sclerosis (ALS). When associated with an increase in load on the respiratory system, this situation may precipitate hypercapnic respiratory failure in non-ventilated patients with ALS. The...

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Publicado en:Respiratory Care Vol. 60; no. 4; pp. 492 - 498
Autores principales: Sancho, Jesus, Servera, Emilio, Bañuls, Pilar, Marin, Julio
Formato: research tables/charts Journal Article
Publicado: Mary Ann Liebert, Inc. Apr2015
Acceso en línea:Ver este registro en EBSCOhost
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      pub: Mary Ann Liebert, Inc.
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        atl: Predictors of Need for Noninvasive Ventilation During Respiratory Tract Infections in Medically Stable, Non-Ventilated Subjects With Amyotrophic Lateral Sclerosis.
      aug:
        au:
          Sancho, Jesus
          Servera, Emilio
          Bañuls, Pilar
          Marin, Julio
        affil: Respiratory Care Unit, Respiratory Medicine Department, Hospital Clinico Universitario; Research Group for Respiratory Problems in Neuromuscular Disease, Institute of Health Research (INCLIVA), Valencia, Spain
      sug:
        subj:
          Noninvasive Procedures
          Respiratory Tract Infections
          Amyotrophic Lateral Sclerosis
          Human
          Predictive Value of Tests
          Prospective Studies
          Male
          Female
          Middle Age
          Aged
          T-Tests
          Descriptive Statistics
          Data Analysis Software
          Chi Square Test
          ROC Curve
          Scales
          Confidence Intervals
          Odds Ratio
          Middle Aged: 45-64 years
          Aged: 65+ years
          Male
          Female
      ab: BACKGROUND: Acute lower respiratory infections can impair muscle strength in patients with amyotrophic lateral sclerosis (ALS). When associated with an increase in load on the respiratory system, this situation may precipitate hypercapnic respiratory failure in non-ventilated patients with ALS. The aim of this study was to determine whether a clinical or functional parameter can predict the need for noninvasive ventilation (NIV) during an acute respiratory infection for medically stable, non-ventilated patients with ALS. METHODS: This was a prospective study involving all non-ventilated subjects with ALS admitted due to an acute respiratory infection to a respiratory care unit from a tertiary hospital. RESULTS: Thirty-two non-ventilated subjects with ALS were admitted to our respiratory care unit due to an acute respiratory infection: 60.72 ± 10.54 y, 13 males, 23 with spinal onset, FVC of 1.58 ± 0.83 L, FVC of 56.21 ± 23.15% of predicted, peak cough flow of 3.41 ± 1.77 L/s, maximum insufflation capacity of 1.87 ± 0.94 L, revised Amyotrophic Lateral Sclerosis Functional Rating Scale score of 22.80 ± 8.83, and Norris bulbar score of 23.48 ± 12.14. Fifteen subjects required NIV during the episode. Logistic regression analysis showed that the only predictors of need for NIV were percent-of-predicted FVC (odds ratio of 1.06, 95% CI 1.01-1.11, P = .02) and peak cough flow (odds ratio of 2.57, 95% CI 1.18-5.59, P = .02). CONCLUSIONS: In medically stable, non-ventilated patients with ALS, measurement of percent-of-predicted FVC and peak cough flow can predict the need for NIV during an acute lower respiratory tract infection.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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