Source: Annual Congress 2002 - Monitoring respiratory parameters in critically ill patients

Abstract

We evaluated the respiratory function, as measured by Forced Vital Capacity (FVC) and expressed in liters and percent predicted, in Amyotrophic Lateral Sclerosis (ALS). Patients were diagnosed using the [dsquote]WFN-El Escorial[dsquote] criteria, and the disease progression assessed over one year by the [dsquote]Appel ALS rating scale[dsquote] (AARS). 27 patients were followed (M/F: 16/11; 61±]10 years old) and, accordingly to AARS, three progression rates of the disease could be identified: slow (SG), intermediate (IG), and rapid (RG). Each progression group consisted of 9 patients. Respiratory impairment was calculated for each patient as a difference of values at 12 month control value and at baseline. Data were analyzed using non-parametric statistical methods. At follow-up, the FVC median difference (CI 95% low/up values) was as follows: SG 6 (-2.5/15), IG 14 (7/34.5), RG 54.5 (40.5/67). Multiple comparison showed a statistically significant difference between RG and SG, and between RG and IG (p<0.0002). Our study show that AARS score identifies ALS patients with different decline of respiratory function. RG patients have a fast FVC deterioration during the one-year follow-up. This group of patients might be eligible for a program of early non-invasive ventilation in the attempt to prevent the rapid decline of respiratory function. Further investigations need to recognize the timing of ventilation.

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D. D'Amico, S. Marchese, M. C. Pesco, R. Bruno, C. Lunetta, D. Lo Coco, S. Corrao, V. La Bella, A. Lo Coco (Palermo, Italy). The appel amyotrophic lateral sclerosis rating scale is predictive of fast FVC deterioration in amyotrophic lateral sclerosis patients. Eur Respir J 2002; 20: Suppl. 38, 624

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