Can Non-invasive Ventilation Settings Predicts Functional and Survival Outcome in ALS Patients?Braga ACM1*, Pinto S1 and Pinto A1,2
- Corresponding Author:
- Anna Caroline Braga
Translational and Clinical Physiology Unit
Institute of Molecular Medicine
Faculty of Medicine, University of Lisbon
1649-028, Lisbon, Portugal
E-mail: [email protected]
Received Date: April 07, 2017; Accepted Date: April 27, 2017; Published Date: April 28, 2017
Citation: Braga ACM, Pinto S, Pinto A (2017) Can Non-invasive Ventilation Settings Predicts Functional and Survival Outcome in ALS Patients?. J Community Med Health Educ 7:521. doi:10.4172/2161-0711.1000521
Copyright: © Braga ACM, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Introduction: The lack of more specific tools, with low costs, that may be associated with the ALSFRS-R (Amyotrophic Lateral Sclerosis Functional Scale-Revised) score to assist in analyzing the prognosis, is a constraint factor in the follow-up of ALS ventilated patients.
Objective: we analyzed the potential predictors of ALSFRS-R functional decline related to Non-Invasive ventilation (NIV) settings, Nocturnal Pulse Oximetry (NPO), and Pulmonary Function Test (PFT).
Methods: Prospective, comparative trial of 60 consecutive ALS patients, compliant to NIV, during 5 years of follow-up. Subjects were assigned to Group 1 (not-survivors) or Group 2 (survivors) at end of study. Data from ALSFRS-R, NPO, PFT and NIV settings were collected once each three months.
Results: No clinical or laboratory differences were observed between groups for any variable at admission. Disease duration from onset as well as Total use of NIV presented non-significant differences at end of study. However, these 2 variables were correlated positively with Expiratory Positive Airways Pressure (EPAP), Inspiratory Positive Airways Pressure (IPAP) and backup breath rate (all parameters of NIV), maximal inspiratory pressure (MIP-PFT), and SpO2mean (NPO). Multivariate Cox regression analysis showed that data from NIV settings and PFT were predictors of functional decline.
Conclusions: For the first time, determinants of functional decline are significantly related to NIV equipment settings as well as to compliance data.