Non invasive ventilation in admitted Amyotrophic Lateral Sclerosis patients with Acute Respiratory Failure

PUJOL LEREIS VIRGINIA; GARGIULO MONACHELLI GM; RODRIGUEZ G; SIVORI M; VILLA A; REY RC

Toronto, Canada

Congreso; 62nd Annual Meeting of the American Academy of Neurology.; 2010

Abstract BACKGROUND: The most frequent cause of death in amyotrophic lateral sclerosis (ALS) is respiratory insufficiency. Despite the existence of recommendations on management of respiratory insufficiency in patients with ALS, there is no agreement when it presents as acute respiratory failure (ARF). OBJECTIVE: We evaluated the efficacy of treatment with non-invasive ventilation (NIV) in ALS patients admitted with ARF. METHODS: We conducted a retrospective study of 13 definite ALS patients who consulted the emergency department for ARF. All patients received conventional treatment (hydration, oxygen therapy, feeding, secretions´ management, respiratory kinesics assistance and antibiotic treatment), 7 patients from the 2000-2006 period without NIV and 6 patients from the 2006-2008 period with NIV. RESULTS: One hundred percent of patients without acute NIV therapy died during their admission in comparison with 16.67% of patients with acute NIV therapy (Fisher p<.005). The average (±SD) survival time from ARF with NIV was 242.6 ± 162.36 days and without NIV 4.43 ± 1.40 days (p<.03). The mean time of evolution from the onset of symptoms of ALS to ARF was 42.5 ± 25.65 months in patient with NVI and 29.43 ± 16.26 months without NVI  (p = NS). CONCLUSIONS: In our study, ALS patients admitted in a general ward for ARF that received NIV had an improved outcome and prolonged survival from the event without the requirement of other invasive measures.