Predictors of non-invasive ventilation tolerance in amyotrophic lateral sclerosis. (Articolo in rivista)

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Label
  • Predictors of non-invasive ventilation tolerance in amyotrophic lateral sclerosis. (Articolo in rivista) (literal)
Anno
  • 2011-01-01T00:00:00+01:00 (literal)
Alternative label
  • Volanti P, Cibella F, Sarvà M, De Cicco D, Spanevello A, Mora G, La Bella V. (2011)
    Predictors of non-invasive ventilation tolerance in amyotrophic lateral sclerosis.
    in Journal of the neurological sciences
    (literal)
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  • Volanti P, Cibella F, Sarvà M, De Cicco D, Spanevello A, Mora G, La Bella V. (literal)
Pagina inizio
  • 114 (literal)
Pagina fine
  • 118 (literal)
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  • 303 (literal)
Rivista
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  • 5 (literal)
Note
  • PubMe (literal)
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  • Neurorehabilitation Unit, Fondazione Salvatore Maugeri, Mistretta (ME) ALS Clinical Research Center, University of Palermo Consiglio Nazionale delle Ricerche, Istituto di Biomedicina e Immunologia Molecolare, Palermo (literal)
Titolo
  • Predictors of non-invasive ventilation tolerance in amyotrophic lateral sclerosis. (literal)
Abstract
  • BACKGROUND: The most frequent cause of death in patients with Amyotrophic Lateral Sclerosis (ALS) is respiratory failure. Recently, it has been shown that non-invasive ventilation improves survival and quality of life in ALS patients with respiratory failure, but little is known about predictors of non-invasive ventilation adaptation and tolerance. In this study we evaluated the effect of a comprehensive information about non-invasive ventilation use and a prolonged and intensive monitoring on tolerance to this palliative care. METHODS: We prospectively monitored all consecutive ALS patients with chronic respiratory failure and indication to non-invasive ventilation between January 2005 and December 2007. Non-invasive ventilation adaptation was always performed in a hospital setting. RESULTS: Forty-four patients were considered eligible: six declined the non-invasive ventilation proposal and one was excluded due to severe fronto-temporal dementia. Non-invasive ventilation was offered to thirty-seven inpatients in our ALS Centre, thirty-two of whom presented with severe (n=9) or mild-moderate (n=23) bulbar impairment at non-invasive ventilation initiation. The mean time interval for adaptation to ventilation was 5±2 days, but patients remained in hospital for an average extended period of one week. Thirty-five of the 37 patients who started non-invasive ventilation, including those with severe bulbar impairment, remained tolerant at twelve months follow-up. CONCLUSIONS: Our study shows that an intensive educational training and adaptation on non-invasive ventilation, when performed in a hospital multidisciplinary setting, increases compliance and tolerance over time, even in those patients with severe bulbar impairment. However, the design of our study, mainly based on a continuous monitoring and educational training of the patients, might not make it fully applicable to an outpatients setting (literal)
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