LONG-TERM MECHANICAL VENTILATION IN AMYOTROPHIC-LATERAL-SCLEROSIS

Background. Acute respiratory insufficiency (ARI) with alveolar hypove ntilation or incapacitating dyspnoea but without peripheral muscle inv olvement can be an early manifestation of respiratory involvement in a myotrophic lateral sclerosis (ALS). Some of these patients benefit fro m assisted ventilation. The object of this study was to analyse the re sults of long-term mechanical ventilation (LTMV) in ten patients with ALS. Methods. A retrospective analysis of intensive care unit (ICU) or ambulant patients with ALS who underwent LTMV in a conventional hospi tal ward was performed. Erect and supine spirometry, blood gas analysi s and pulse oximetry were performed before the start and during the co urse of ventilation. Results. Ten patients on LTMV were included. Four from the ICU were ventilated via tracheostomy, and six ambulant patie nts had non-invasive (nasal) ventilation. In all cases, ventilation wa s performed in a conventional hospital ward. The ambulant patients imp roved symptomatically during ventilation, confirmed by measurement of gas exchange and of SaO(2) by continuous pulse oximetry. Three of the ten patients survive in long-term care - two with nasal and one with t racheostomy ventilation. Conclusions. LTMV outside ICU was possible in ten patients, seven of whom returned home. Returning home is very dif ficult for patients dependent on a ventilator who lack family support.