Current issues in the respiratory care of patients with amyotrophic lateral sclerosis.
Amyotrophic lateral sclerosis is a progressive neuromuscular disease, resulting in respiratory muscle weakness, reduced pulmonary volumes, ineffective cough, secretion retention, and respiratory failure. Measures as vital capacity, maximal inspiratory and expiratory pressures, sniff nasal inspiratory pressure, cough peak flow and pulse oximetry are recommended to monitor the respiratory function. The patients should be followed up by a multidisciplinary team, focused in improving the quality of life and deal with the respiratory symptoms. The respiratory care approach includes airway clearance techniques, mechanically assisted cough and noninvasive mechanical ventilation. Vaccination and respiratory pharmacological support are also recommended. To date, there is no enough evidence supporting the inspiratory muscle training and diaphragmatic pacing.
Centro Universitário Augusto Motta, Rio de Janeiro, RJ, BR.
Marco
M
Orsini
Centro Universitário Augusto Motta, Rio de Janeiro, RJ, BR.
Agnaldo José
AJ
Lopes
Centro Universitário Augusto Motta, Rio de Janeiro, RJ, BR.
Sara Lucia Silveira de
SL
Menezes
Departamento de Neurologia, Universidade Federal de São Paulo, São Paulo, SP, BR.
Acary Bulle
AB
Oliveira
Departamento de Neurologia, Universidade Federal Fluminense, Niteroi, RJ, BR.
Marcos Raimundo Gomes de
MR
Freitas
Departamento de Neurologia, Universidade Federal Fluminense, Niteroi, RJ, BR.
Osvaldo Jose Moreira do
OJ
Nascimento
Centro Universitário Augusto Motta, Rio de Janeiro, RJ, BR.
Fernando Silva
FS
Guimarães
D000690:Amyotrophic Lateral Sclerosis / Q000503:physiopathology / Q000628:therapy*; D006801:Humans; D053580:Muscle Strength; D018908:Muscle Weakness / Q000503:physiopathology; D011659:Pulmonary Gas Exchange; D012131:Respiratory Insufficiency / Q000503:physiopathology / Q000628:therapy*; D012138:Respiratory Therapy / Q000379:methods*; D013147:Spirometry