Perrin C
Service de Pneumologie, Centre Hospitalier de Cannes.
Rev Neurol (Paris). 2006 Jun;162 Spec No 2:4S261-4S265.
Respiratory muscle weakness represents the major cause of mortality in patients with amyotrophic lateral sclerosis (ALS). As a result, ventilatory assistance is an important part of disease management. Nowadays, noninvasive ventilation (NIV) has become the first choice modality for most patients and represents an alternative to tracheostomy intermittent positive-pressure ventilation. Although, some consensus guidelines have been proposed to initiate NIV in patients with restrictive chronic respiratory failure, these criteria are discussed regarding ALS. While the current consensus recommends that NIV may be used in symptomatic patients with hypercapnia or forced vital capacity<50p.cent of predicted value, early use of NIV is proposed in the literature and reported in this paper.
呼吸肌无力是肌萎缩侧索硬化症(ALS)患者死亡的主要原因。因此,通气支持是疾病管理的重要组成部分。如今,无创通气(NIV)已成为大多数患者的首选方式,是气管切开间歇性正压通气的替代方法。尽管已经提出了一些共识性指南来启动限制性慢性呼吸衰竭患者的无创通气,但这些标准在ALS方面仍存在争议。虽然目前的共识建议无创通气可用于有高碳酸血症或用力肺活量<预测值50%的有症状患者,但文献中提出并在本文中报道了无创通气的早期使用。