Longitudinal effects of noninvasive positive-pressure ventilation in patients with amyotrophic lateral sclerosis.
OBJECTIVE
To evaluate the duration of benefit on symptoms, quality of life, and survival derived from the use of noninvasive positive-pressure ventilation by patients with amyotrophic lateral sclerosis.


METHODS
In this prospective, cohort study, 30 of 36 consecutively referred symptomatic patients tolerated nightly noninvasive positive-pressure ventilation and undertook pulmonary function testing and 12 symptom and quality-of-life instruments concerning sleep quality, daytime sleepiness, physical fatigue, mental fatigue, and depression that were administered during a 10-mo period.


RESULTS
With treatment, there was a significant improvement in the majority of patients in sleep quality, daytime sleepiness, physical fatigue, and depression; however, significant improvements lasted for up to 10 mo only in sleep quality. Partial pressure of arterial oxygen, partial pressure of arterial carbon dioxide, and oxyhemoglobin saturation remained stable or even improved for up to 7 mo during use of part-time noninvasive positive-pressure ventilation. A total of 14 patients had survival prolonged by continuous dependence on noninvasive positive-pressure ventilation.


CONCLUSIONS
Noninvasive positive-pressure ventilation provides a long-lasting benefit on symptoms and quality of life indicators for amyotrophic lateral sclerosis patients and should be offered to all patients with symptoms of sleep disordered breathing or inspiratory muscle dysfunction. It can also prolong tracheostomy-free survival.
Butz
Miriam
M
Department of Neurology, University of Ulm, Ulm, Germany.
Wollinsky
Kurt H
KH
Wiedemuth-Catrinescu
Ursula
U
Sperfeld
Anne
A
Winter
Susanne
S
Mehrkens
Hans H
HH
Ludolph
Albert C
AC
Schreiber
Herbert
H
D000328:Adult; D000368:Aged; D000690:Amyotrophic Lateral Sclerosis / Q000401:mortality / Q000503:physiopathology / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011175:Positive-Pressure Respiration; D011446:Prospective Studies; D011788:Quality of Life; D012129:Respiratory Function Tests; D012890:Sleep; D015996:Survival Rate