Amyotrophic lateral sclerosis: prospective study on respiratory parameters

Abstract

Objective: To verify how efficient respiratory parameters are in the follow-up of subjects with amyotrophic lateral sclerosis (ALS) and to observe possible correlations between respiratory and nutritional functions. Method: Sixteen patients with probable or defined ALS were selected and evaluated over eight months using the following respiratory parameters: spirometry, maximum inspiratory pressure (MIP), maximum expiratory pressure (MEP), arterial gasometry and pulse oximetry; and nutritional parameters such as body mass index (BMI) and percentage weight loss. Results: P a CO 2 was a significant parameter to follow up disease evolution (p=0.051). There was significant correlation between MIP and MEP (r: 0.83); BMI and MIP (r: 0.70); BMI and MEP (r: 0.72); pulse oximetry and forced vital capacity (r: 0.57). Conclusion: P a CO 2 was shown to be an efficient and significant parameter in the measurement of respiratory impairment; the correlations among MIP, MEP and BMI indicated that these are significant parameters for periodic clinical evaluation. Key words: amyotrophic lateral sclerosis, maximum inspiratory pressure, maximum expiratory pressure, body mass index.Esclerose lateral amiotrófica: estudo prospectivo de parâmetros respiratórios RESUMO Objetivo: Verificar a eficácia dos parâmetros respiratórios na evolução de indivíduos com esclerose lateral amiotrófica (ELA) e identificar possíveis correlações entre função respiratória e nutricional. Método: 16 pacientes com diagnóstico provável ou definido de ELA foram selecionados por critérios definidos e avaliados, durante 8 meses, através de parâmetros respiratórios: espirometria, pressão inspiratória máxima (PIM), pressão expiratória máxima (PEM), gasometria arterial e oximetria de pulso; e parâmetros nutricionais: índice de massa corporal (IMC) e porcentagem de perda de peso. Resultados: P a CO 2 foi um parâmetro significativo para acompanhar a evolução da doença (p=0.051). Houve correlação significante entre PIM e PEM (r: 0.83); IMC e PIM (r: 0.70); IMC e PEM (r: 0.72); oximetria de pulso e capacidade vital forçada (r: 0.57). Conclusão: P a CO 2 foi marcador eficaz e significante para medir o comprometimento respiratório; correlações entre PIM, PEM e IMC indicaram ser bons parâmetros nas avaliações clínicas periódicas. Palavras-chave: esclerose lateral amiotrófica, pressão inspiratória máxima, pressão expiratória máxima, índice de massa corporal.

Inteligibilidade de fala em pessoas com Esclerose Lateral Amiotrófica (ELA)

“…Our findings related to breathing showed the presence of mild to moderate impairment, similar to the literature that indicates the presence of impairment of this function in ALS, affecting the inspiratory, expiratory, and bulbar muscles and can generate oxygen desaturation due to hypercapnia, cough and excessive saliva aspiration. In advanced stages of the disease, it is also possible to observe symptoms of respiratory muscle weakness, such as dyspnea on exertion, fatigue, morning headache, or sleep disorders, culminating in nocturnal hypoventilation, most of the times with the need to use mechanical ventilation (20) .…”

Monitoring respiratory muscle strength assists in early diagnosis of respiratory dysfunction as opposed to the isolated use of pulmonary function evaluation in amyotrophic lateral sclerosis

“…In a similar study, Almeida et al 27 evaluated 16 patients diagnosed with probable or definite ALS over 8 months, using spirometry, maximal respiratory pressures, arterial gasometry, pulse oximetry, BMI and percentage weight loss. The authors found that PCO 2 was a significant parameter to monitor the evolution of the disease during the study period (p=0.051).…”

Respiratory Muscle Training for Respiratory Deficits in Neurodegenerative Disorders

“…1,3,[7][8][9][10][11][12] In this group of diseases, patients have in common the weakness of inspiratory and expiratory muscles and muscles involved in speech, swallowing, and airway protection, thus increasing the risk of aspiration pneumonia. 3,4,6,9,[13][14][15][16][17] These patients generally have poor exercise tolerance and show fatigue and dyspnea on exertion. This limits their ability to perform activities Background: Studies of the impact of respiratory muscle training (RMT) on central neurodegenerative pathologies have been aimed at improving pulmonary function.…”