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Predictors of need for noninvasive ventilation during respiratory tract infections in medically stable, non-ventilated subjects with amyotrophic lateral sclerosis.
Sancho, Jesus; Servera, Emilio; Bañuls, Pilar; Marin, Julio.
Afiliación
  • Sancho J; Respiratory Care Unit, Respiratory Medicine Department, Hospital Clinico Universitario, and the Research Group for Respiratory Problems in Neuromuscular Disease, Institute of Health Research (INCLIVA), Valencia, Spain. jesus.sancho@uv.es.
  • Servera E; Respiratory Care Unit, Respiratory Medicine Department, Hospital Clinico Universitario, and the Research Group for Respiratory Problems in Neuromuscular Disease, Institute of Health Research (INCLIVA), Valencia, Spain. Department of Physical Therapy.
  • Bañuls P; Respiratory Care Unit, Respiratory Medicine Department, Hospital Clinico Universitario, and the Research Group for Respiratory Problems in Neuromuscular Disease, Institute of Health Research (INCLIVA), Valencia, Spain.
  • Marin J; Department of Medicine, Universitat de Valencia, Valencia, Spain.
Respir Care ; 60(4): 492-7, 2015 Apr.
Article en En | MEDLINE | ID: mdl-25406348
BACKGROUND: Acute lower respiratory infections can impair muscle strength in patients with amyotrophic lateral sclerosis (ALS). When associated with an increase in load on the respiratory system, this situation may precipitate hypercapnic respiratory failure in non-ventilated patients with ALS. The aim of this study was to determine whether a clinical or functional parameter can predict the need for noninvasive ventilation (NIV) during an acute respiratory infection for medically stable, non-ventilated patients with ALS. METHODS: This was a prospective study involving all non-ventilated subjects with ALS admitted due to an acute respiratory infection to a respiratory care unit from a tertiary hospital. RESULTS: Thirty-two non-ventilated subjects with ALS were admitted to our respiratory care unit due to an acute respiratory infection: 60.72 ± 10.54 y, 13 males, 23 with spinal onset, FVC of 1.58 ± 0.83 L, FVC of 56.21 ± 23.15% of predicted, peak cough flow of 3.41 ± 1.77 L/s, maximum insufflation capacity of 1.87 ± 0.94 L, revised Amyotrophic Lateral Sclerosis Functional Rating Scale score of 22.80 ± 8.83, and Norris bulbar score of 23.48 ± 12.14. Fifteen subjects required NIV during the episode. Logistic regression analysis showed that the only predictors of need for NIV were percent-of-predicted FVC (odds ratio of 1.06, 95% CI 1.01-1.11, P = .02) and peak cough flow (odds ratio of 2.57, 95% CI 1.18-5.59, P = .02). CONCLUSIONS: In medically stable, non-ventilated patients with ALS, measurement of percent-of-predicted FVC and peak cough flow can predict the need for NIV during an acute lower respiratory tract infection.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Insuficiencia Respiratoria / Infecciones del Sistema Respiratorio / Ventilación no Invasiva / Esclerosis Amiotrófica Lateral Tipo de estudio: Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Respir Care Año: 2015 Tipo del documento: Article País de afiliación: España Pais de publicación: Estados Unidos
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Insuficiencia Respiratoria / Infecciones del Sistema Respiratorio / Ventilación no Invasiva / Esclerosis Amiotrófica Lateral Tipo de estudio: Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Respir Care Año: 2015 Tipo del documento: Article País de afiliación: España Pais de publicación: Estados Unidos