Non-invasive ventilation effectiveness and the effect of ventilatory mode on survival in ALS patients. Issue 1 (March 2014)

• Record Type: Journal Article
• Authors: Sancho, Jesus; Servera, Emilio; Morelot-Panzini, Capucine; Salachas, François; Similowski, Thomas; Gonzalez-Bermejo, Jesus
• Is Part Of: Amyotrophic lateral sclerosis and frontotemporal degeneration. Volume 15:Issue 1/2(2014)
• Page Start: 55
• Page End: 61
• Publication Date: 2014-03
• Subjects: 616.839
• DOI: 10.3109/21678421.2013.855790
• Languages: English
• ISSNs: 2167-8421

Abstract

<abstract> <title>Abstract</title> <p>Non-invasive ventilation (NIV) prolongs survival in amyotrophic lateral sclerosis (ALS), but there are no data with which to compare the effectiveness of the different ventilator modes – volume (Vol-NIV) or pressure-cycled (Pres-NIV) ventilation – in ALS. We aimed to determine whether the ventilatory mode has an effect on ventilation effectiveness and survival of ALS patients using NIV. We used a retrospective study that included all ALS patients for whom NIV was indicated in two referral units: one using Vol-NIV and the other using Pres-NIV. Demographic, functional and nocturnal gas exchange parameters at NIV initiation were recorded. Eighty-two ALS patients ventilated using Pres-NIV and 62 using Vol-NIV were included. No differences were found in survival from NIV initiation between Vol-NIV (median 15.00 (7.48–22.41) months) and Pres-NIV (median 15.00 (10.25–19.75) months, <italic>p = </italic>0.533) patients. Effective NIV was achieved in 72.41% Vol-NIV patients and in 48.78% Pres-NIV patients (<italic>p < </italic>0.001). Ventilator mode (OR 12.066 (4.251–32.270), <italic>p < </italic>0.001) and severity of bulbar dysfunction (OR 1.07 (1.011–1.133), <italic>p = </italic> 0.02) were the variables correlated with effective NIV. In conclusion, although Vol-NIV provides more effective ventilation, Vol-NIV and Pres-NIV present similar survival in ALS. Effectiveness of NIV is related to the severity of bulbar dysfunction.</p> </abstract>