title: Early respiratory insufficiency in the ALS patient: a case study.
abstract: Respiratory insufficiency is a problem that develops in nearly all people diagnosed with amyotrophic lateral sclerosis (ALS). Noninvasive positive pressure ventilation (NIPPV) is the treatment of choice for ALS patients with respiratory insufficiency. Forced vital capacity (FVC) is the test most commonly used to qualify ALS patients for NIPPV; however, some research suggests FVC may not be the best tool to measure early respiratory insufficiency in all patients with ALS. This case study introduces an ALS patient who had normal FVC results, symptoms of respiratory insufficiency, and abnormal nocturnal oximetry. After NIPPV initiation, the patient reported improved sleep and less daytime fatigue, which he associated with the start of NIPPV treatment.
authors.affiliation: Greater Philadelphia Chapter of the ALS Association, Ambler, PA, USA. gail@alsphiladelphia.org
authors.forename: Gail
authors.initials: G
authors.lastname: Houseman
authors.forename: Mary
authors.initials: M
authors.lastname: Kelley
mesh_terms: D000690:Amyotrophic Lateral Sclerosis / Q000150:complications*; D018450:Disease Progression; D006801:Humans; D008297:Male; D008875:Middle Aged; D024802:Nurse's Role; D009730:Nursing Assessment; D010092:Oximetry; D018579:Patient Selection; D017286:Polysomnography; D011175:Positive-Pressure Respiration; D012016:Reference Values; D015203:Reproducibility of Results; D012129:Respiratory Function Tests / Q000379:methods / Q000592:standards; D012131:Respiratory Insufficiency / Q000175:diagnosis* / Q000209:etiology / Q000628:therapy*; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D016683:Supine Position; D013997:Time Factors; D014797:Vital Capacity