J Korean Acad Rehabil Med.  2010 Feb;34(1):49-53.

A Survey of Respiratory Care in Amyotrophic Lateral Sclerosis Patients Using Non-invasive Ventilatory Support

• Kim JY
• Min Y
• Kim MS
• Kim JS
• Kim HL
• Shin HI

Abstract

OBJECTIVE
To investigate the current status of respiratory care in community-dwelling amyotrophic lateral sclerosis (ALS) patients using non-invasive ventilatory support. METHOD: Trained investigators visited patients' homes in order to conduct the survey. Questions regarding the time since diagnosis and ventilatory support, department and type of ventilator were asked. The parameters of mechanical ventilation were noted. The presence of respiratory symptoms, frequency of oxygen saturation monitoring, maneuvers for sputum clearance and frequency of air stacking exercise were also investigated.
RESULTS
Data from 169 individuals were analyzed. The mean age was 59.1+/-12.5 years, time since diagnosis was 48.0+/-42.8 months and duration of ventilatory support was 25.7+/-20.8 months. The types of ventilator used were significantly different according to the medical departments where they had been prescribed. More than 50% of the subjects had sleep awakening, shortness of breath or daytime drowsiness despite ventilatory support. Air stacking exercises were performed in 8.8%. Sputum clearing maneuvers such as manually assisted cough, mechanical in/ex-sufflation or postural drainage were used by 13.6% of the individuals. Only 16.0% of the patients checked their oxygen saturation level more than once a day.
CONCLUSION
Current respiratory care is inappropriate in ALS patients using non-invasive ventilatory support at home. The current system for ventilator prescription and monitoring needs modification to improve the respiratory care status.

Keyword

Amyotrophic lateral sclerosis; Positive-pressure respiration; Respiratory therapy

MeSH Terms

Amyotrophic Lateral Sclerosis
Cough
Drainage, Postural
Dyspnea
Exercise
Humans
Oxygen
Positive-Pressure Respiration
Prescriptions
Research Personnel
Respiration, Artificial
Respiratory Therapy
Sleep Stages
Sputum
Ventilators, Mechanical
Oxygen