title: Capnography for assessing nocturnal hypoventilation and predicting compliance with subsequent noninvasive ventilation in patients with ALS.
abstract: BACKGROUND
  Patients with amyotrophic lateral sclerosis (ALS) suffer from hypoventilation, which can easily worsen during sleep. This study evaluated the efficacy of capnography monitoring in patients with ALS for assessing nocturnal hypoventilation and predicting good compliance with subsequent noninvasive ventilation (NIV) treatment.
  
  
  METHODS
  Nocturnal monitoring and brief wake screening by capnography/pulse oximetry, functional scores, and other respiratory signs were assessed in 26 patients with ALS. Twenty-one of these patients were treated with NIV and had their treatment compliance evaluated.
  
  
  RESULTS
  Nocturnal capnography values were reliable and strongly correlated with the patients' respiratory symptoms (R(2) = 0.211-0.305, p = 0.004-0.021). The duration of nocturnal hypercapnea obtained by capnography exhibited a significant predictive power for good compliance with subsequent NIV treatment, with an area-under-the-curve value of 0.846 (p = 0.018). In contrast, no significant predictive values for nocturnal pulse oximetry or functional scores for nocturnal hypoventilation were found. Brief waking supine capnography was also useful as a screening tool before routine nocturnal capnography monitoring.
  
  
  CONCLUSIONS
  Capnography is an efficient tool for assessing nocturnal hypoventilation and predicting good compliance with subsequent NIV treatment of ALS patients, and may prove useful as an adjunctive tool for assessing the need for NIV treatment in these patients.
authors.affiliation: Department of Neurology, Seoul National University College of Medicine, Seoul, Korea.
authors.forename: Sung-Min
authors.initials: SM
authors.lastname: Kim
authors.forename: Kyung Seok
authors.initials: KS
authors.lastname: Park
authors.forename: Hyunwoo
authors.initials: H
authors.lastname: Nam
authors.forename: Suk-Won
authors.initials: SW
authors.lastname: Ahn
authors.forename: Suhyun
authors.initials: S
authors.lastname: Kim
authors.forename: Jung-Joon
authors.initials: JJ
authors.lastname: Sung
authors.forename: Kwang-Woo
authors.initials: KW
authors.lastname: Lee
mesh_terms: D000328:Adult; D000368:Aged; D000690:Amyotrophic Lateral Sclerosis / Q000150:complications* / Q000503:physiopathology*; D019296:Capnography / Q000379:methods*; D002245:Carbon Dioxide / Q000032:analysis; D003624:Darkness; D003710:Demography; D005260:Female; D006801:Humans; D007040:Hypoventilation / Q000150:complications / Q000175:diagnosis* / Q000503:physiopathology / Q000628:therapy; D008297:Male; D008875:Middle Aged; D010092:Oximetry; D010349:Patient Compliance; D012372:ROC Curve; D015203:Reproducibility of Results; D012119:Respiration; D012121:Respiration, Artificial; D016683:Supine Position / Q000502:physiology; D014851:Wakefulness / Q000502:physiology
chemical_list: D002245:Carbon Dioxide