Anesthetic management of the patient with amyotrophic lateral sclerosis

Prabhakar, Amit; Owen, Christopher Paul; Kaye, Alan D.

doi:10.1007/s00540-013-1644-2

Cited by 26 publications

(26 citation statements)

References 25 publications

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“…Clinical assessment of these donor candidates should include evaluation for (1) bulbar symptoms, as the latter may be associated with a higher likelihood of perioperative aspiration events; and (2) the risk of perioperative pulmonary complications (including the ability to extubate early postoperatively). On spirometry, observed values for FVC and FEV 1 should be >75% of predicted values . Minimization of perioperative pulmonary morbidity also requires judicious choice and dosing of anesthetic agents .…”

Section: Discussionmentioning

confidence: 99%

“…On spirometry, observed values for FVC and FEV 1 should be >75% of predicted values . Minimization of perioperative pulmonary morbidity also requires judicious choice and dosing of anesthetic agents . Fortunately, optimal use of muscle relaxants, inhaled gases, and parenteral narcotics has been well characterized for ALS patients, since they do not uncommonly require procedures under general anesthesia (eg, open gastrostomy tube placement) .…”

Section: Discussionmentioning

confidence: 99%

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Barriers to live and deceased kidney donation by patients with chronic neurological diseases: Implications for donor selection, donation timing, logistics, and regulatory compliance

Troppmann

Santhanakrishnan

Sageshima

et al. 2019

American Journal of Transplantation

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Live and deceased kidney donation by the numerous patients with advanced, progressive systemic neurological diseases, and other chronic neurological conditions (eg, high C‐spine injury) remains largely unexplored. In a review of our current clinical practice, we identified multiple regulatory and clinical barriers. For live donation, mandatory reporting of postdonation donor deaths within 2 years constitutes a strong programmatic disincentive. We propose that the United Network for Organ Sharing should provide explicit regulatory guidance and reassurance for programs wishing to offer live donation to patients at higher risk of death during the reporting period. Under the proposal, live donor deaths within 30 days would still be regarded as donation‐related, but later deaths would be related to the underlying disease. For deceased donation, donation after circulatory death (DCD) immediately following self‐directed withdrawal of life‐sustaining treatment (“conscious DCD”) is not universally covered by existing DCD agreements with donor hospitals. Organ procurement organizations should thus systematically strive to revise these agreements. Obtaining adequate first‐person consent from these communicatively severely impaired patients may be challenging. Optimized preservation and allocation protocols may maximize utilization of these DCD kidneys. Robust public debate and action by all stakeholders is necessary to lower existing barriers and maximize donation opportunities for patients with chronic neurological conditions.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Barriers to live and deceased kidney donation by patients with chronic neurological diseases: Implications for donor selection, donation timing, logistics, and regulatory compliance

Troppmann

Santhanakrishnan

Sageshima

et al. 2019

American Journal of Transplantation

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“…24 Anesthetic considerations include the use of regional or neuraxial anesthesia, reversible and short-acting agents, and complete avoidance of succinylcholine due to the risk of hyperkalemia. 7,18,25 Muscular Dystrophies…”

Section: Amyotrophic Lateral Sclerosismentioning

confidence: 99%

Perioperative Consultation for Patients with Preexisting Neurologic Disorders

Hudson

Greene

2015

Semin Neurol

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As the population ages, the prevalence of many neurologic diseases is increasing. At the same time, older patients are undergoing more surgical procedures. This confluence of events puts neurohospitalists in a unique position to provide both pre- and postoperative guidance to minimize complications, improve clinical outcomes, and decrease health care costs in patients with neurologic comorbidities. Early preoperative consultation is recommended for patients with severe, poorly controlled, or decompensated neurologic disease, a recent stroke, or those undergoing procedures with a high risk of neurologic complications. The neurohospitalist's role includes optimizing management of preexisting diseases, such as epilepsy, neuromuscular disorders, Parkinson's disease, dementia, and cerebrovascular disease, as well as providing guidance for perioperative management and clarification of risks. In the postoperative period, the neurohospitalist will frequently be consulted to mitigate any negative impact of neurologic complications that do occur.

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“…Inhalational agents can cause postoperative respiratory depression; and thus, extubation should be done when the patient is fully awake. 63 …”

Section: Surgical Risksmentioning

confidence: 99%

Palliative Care Issues in Amyotrophic Lateral Sclerosis

Karam

Paganoni

Joyce

et al. 2014

Am J Hosp Palliat Care

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As palliative care physicians become increasingly involved in the care of patients with amyotrophic lateral sclerosis (ALS), they will be asked to provide guidance regarding the use of supplements, diet, exercise, and other common preventive medicine interventions. Moreover, palliative care physicians have a crucial role assisting patients with ALS in addressing health care decisions to maximize quality of life and cope with a rapidly disabling disease. It is therefore important for palliative care physicians to be familiar with commonly encountered palliative care issues in ALS. This article provides an evidenced-based review of palliative care options not usually addressed in national and international ALS guidelines.

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Anesthetic management of the patient with amyotrophic lateral sclerosis

Cited by 26 publications

References 25 publications

Barriers to live and deceased kidney donation by patients with chronic neurological diseases: Implications for donor selection, donation timing, logistics, and regulatory compliance

Barriers to live and deceased kidney donation by patients with chronic neurological diseases: Implications for donor selection, donation timing, logistics, and regulatory compliance

Perioperative Consultation for Patients with Preexisting Neurologic Disorders

Palliative Care Issues in Amyotrophic Lateral Sclerosis

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