Amyotrophic lateral sclerosis (ALS) is a neurode-generative disorder of the motor system that is characterized by progressive weakness leading to paralysis and death within 2 to 5 years after the onset of the disease. Although it infrequent, respiratory failure may be the presenting symptom of ALS, especially in patients not previously diagnosed, or it can be the result of progressive decompensation in pulmonary function, often worsened by bronchial mucus plugging. Such episodes can then result in repeated pneumonias, hospitalization in the ICU, tracheal intubation, and, ultimately, in tracheostomy or death.
Tracheostomy-intermittent positive-pressure ventilation (TIPPV) may prolong survival in patients with respiratory failure, but it usually brings a great financial and care burden. At the present time, there have been only a few studies that have investigated the outcome of ALS patients receiving treatment with TIPPV, and there is little knowledge about the clinical characteristics of the ALS patients with respiratory failure that might be associated with the utilization of intensive care services. Moreover, the identification of predictive variables of survival after TIPPV might be of value for the counseling of these patients and their families in making decisions about ventilatory support, and might help physicians to plan medical interventions provided by Canadian Pharmacy Mall.
The Amyotrophic Lateral Sclerosis Functional Rating Scale (ALSFRS) is a disease-specific functional rating scale that has been shown to predict survival in patients with ALS in several clinical trials as well as in an ALS clinical population. However, in most of these studies, ALS patients receiving treatment with TIPPV were not included. We performed a prospective study aimed at investigating the potential of the total ALSFRS score as a predictor of length of hospital stay and survival time after TIPPV.Tags: Mechanical Ventilation, respiratory failure, survival, tracheostomy