Spirometry in Amyotrophic Lateral Sclerosis

Fallat, Robert J.; Jewitt, Barbara; Bass, Michael; Kamm, Barbara; Norris, Forbes H.

doi:10.1001/archneur.1979.00500380044004

Cited by 190 publications

(105 citation statements)

References 17 publications

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“…A VC less than 1 L (or less than 25 to 30% of predicted) indicates significant risk of impending respiratory failure or death. 65 Bulbar impairment increases the risk of aspiration, 64 and acute respiratory infection can precipitate sudden respiratory failure. 64 Does noninvasive ventilation improve respiratory function or increase survival?…”

Section: Recommendationsmentioning

confidence: 99%

Practice parameter: The care of the patient with amyotrophic lateral sclerosis (an evidence-based review) [RETIRED]

et al. 1999

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(AAN) is charged with developing practice parameters for physicians. This evidence-based review addresses some of the major management issues in patients with ALS, and highlights the many areas in which more research is needed.Justification. ALS is a progressive, degenerative motor neuron disease of unknown cause. Muscle atrophy and spasticity in limb and bulbar muscles result in weakness and loss of ambulation, oropharyngeal dysfunction, weight loss, and ultimately respiratory failure. Although advances in understanding the pathophysiology of ALS have stimulated the development of new drug therapies, 1 the mainstay of treatment for ALS patients remains symptomatic management.The practice parameters presented here comprise the first recommendations for the management of ALS based on a prescribed review and analysis of the peer-reviewed literature. These practice parameters were developed to improve the care and the quality of life of people with ALS by providing a rational basis for managing the disease.Description of the process. A multidisciplinary task force, all with extensive ALS experience, included 19 physicians, 3 patients with ALS, 1 gastroenterologist, 1 pulmonologist, 1 occupational therapist whose mother has ALS, and 1 nurse. In addition, consultants with expertise on ethics, practice parameter development, and medical library research participated in the process. The task force agreed to investigate five areas: 1) informing the patient and the family about the diagnosis and prognosis (also called "breaking the news") of ALS; 2) symptomatic treatment; 3) nutrition, and decisions about percutaneous endoscopic gastroscopy (PEG); 4) respiratory insufficiency and mechanical ventilation; and 5) advance directives and palliative care. To help achieve this goal, they developed several guiding principles or attributes of care: Principles of ALS management1. High priority should be placed on patient self-determination or autonomy as an underlying assumption in the therapeutic relationship. Delivery of both information and care must take into consideration the cultural and psychosocial context of the patient and the family. 2. Patients and families need information that is timed appropriately for decision making, and delivered well in advance of major management crossroads, especially for respiratory care. Moreover, decision making is a dynamic process that may be subject to change as the disease becomes more severe.The investigators and institutions of the ALS Practice Parameters Task Force are listed in the Appendix on page 1320.

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Section: Recommendationsmentioning

confidence: 99%

Practice parameter: The care of the patient with amyotrophic lateral sclerosis (an evidence-based review) [RETIRED]

et al. 1999

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“…The involvement of the respiratory muscles (RMs) leading to dyspnoea and respiratory failure, is the most common cause of death in these patients [1,2]. Respiratory symptoms usually appear late, and the monitoring of lung and RM function have been reported to be the best prognostic indicators in these patients [3][4][5]. Most patients with ALS have reduced forced vital capacity (FVC) which is reported to be related to the presence of respiratory symptoms, and declines progressively with time [3,4,6].…”

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confidence: 99%

Breathing pattern and respiratory mechanics in patients with amyotrophic lateral sclerosis

et al. 1997

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“…Inspiratory and expiratory muscle weakness can be assessed by routine respiratory function measurements. 6,7 Patients with ALS usually die from hypoventilation, 8 with hypoxemia and hypercapnia often precipitated by respiratory infections, aspiration pneumonia, or bronchial impaction. 9 The first study of NIV in ALS reported that continuous daily use delayed or even eliminated the need for a tracheostomy.…”

Section: When To Start Niv?mentioning

confidence: 99%

Hot Topics in Noninvasive Ventilation: Report of a Working Group at the International Symposium on Sleep-Disordered Breathing in Leuven, Belgium

et al. 2015

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During the last few decades, attention has increasingly focused on noninvasive ventilation (NIV) in the treatment of chronic respiratory failure. The University of Leuven and the University Hospitals Leuven therefore chose this topic for a 2-day working group session during their International Symposium on Sleep-Disordered Breathing. Numerous European experts took part in this session and discussed (1) NIV in amyotrophic lateral sclerosis (when to start NIV, NIV and sleep, secretion management, and what to do when NIV fails), (2) recent insights in NIV and COPD (high-intensity NIV, NIV in addition to exercise training, and NIV during exercise training), (3) monitoring of NIV (monitoring devices, built-in ventilator software, leaks, and asynchronies) and identifying events during NIV; and (4) recent and future developments in NIV (target-volume NIV, electromyography-triggered NIV, and autoregulating algorithms)

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Spirometry in Amyotrophic Lateral Sclerosis

Cited by 190 publications

References 17 publications

Practice parameter: The care of the patient with amyotrophic lateral sclerosis (an evidence-based review) [RETIRED]

Practice parameter: The care of the patient with amyotrophic lateral sclerosis (an evidence-based review) [RETIRED]

Breathing pattern and respiratory mechanics in patients with amyotrophic lateral sclerosis

Hot Topics in Noninvasive Ventilation: Report of a Working Group at the International Symposium on Sleep-Disordered Breathing in Leuven, Belgium

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