Early use of non-invasive ventilation prolongs survival in subjects with ALS

Noah Lechtzin, Yanille Scott, Anne M. Busse, Lora L. Clawson, Richard Kimball, Charles M. Wiener

Research output: Contribution to journalArticle

Abstract

Non-invasive positive pressure ventilation (NPPV) can improve survival in ALS patients with advanced respiratory impairment, but it is not known if it is beneficial earlier in the disease course. A retrospective cohort study of patients with ALS was performed comparing survival from time of diagnosis in subjects who started NPPV use when their FVC was ≥65% predicted (Early NPPV) with subjects who started NPPV when their FVC was below 65% predicted (Standard NPPV). The Early group (n=25) and the Standard group (n=67) were similar except for pulmonary function (mean FVC in Early NPPV group=74.3±10.1% predicted and 48.3±11.3 in Standard group, p=0.001). The median time from ALS diagnosis to death was significantly longer in the Early NPPV group (2.7 years vs. 1.8 years, p=0.045). This remained significant after adjustment for potential confounding factors (H.R.=0.55, 95% CI 0.31-0.98). Survival from time of diagnosis was nearly one year longer in the Early group. Until more definitive data are available from randomized trials, our findings suggest that clinicians either encourage earlier use of NPPV or use more sensitive tests for respiratory muscle impairment than upright FVC.

Original languageEnglish (US)
Pages (from-to)185-188
Number of pages4
JournalAmyotrophic Lateral Sclerosis
Volume8
Issue number3
DOIs
StatePublished - Jun 14 2007

Keywords

  • Amyotrophic lateral sclerosis
  • Neuromuscular disease
  • Non-invasive ventilation
  • Pulmonary function test

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology

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