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    Management of respiratory symptoms in ALS.

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    Authors
    Hardiman, Orla
    Affiliation
    HRB Clinician Scientist, Trinity College and Beaumont Hospital, Dublin, Ireland, orla@hardiman.net.
    Issue Date
    2011-03
    
    Metadata
    Show full item record
    Citation
    Management of respiratory symptoms in ALS. 2011, 258 (3):359-65 J. Neurol.
    Journal
    Journal of neurology
    URI
    http://hdl.handle.net/10147/126128
    DOI
    10.1007/s00415-010-5830-y
    PubMed ID
    21082322
    Abstract
    Respiratory insufficiency is a frequent feature of ALS and is present in almost all cases at some stage of the illness. It is the commonest cause of death in ALS. FVC is used as important endpoint in many clinical trials, and in decision-making events for patients with ALS, although there are limitations to its predictive utility. There are multiple causes of respiratory muscle failure, all of which act to produce a progressive decline in pulmonary function. Diaphragmatic fatigue and weakness, coupled with respiratory muscle weakness, lead to reduced lung compliance and atelectasis. Increased secretions increase the risk of aspiration pneumonia, which further compromises respiratory function. Bulbar dysfunction can lead to nutritional deficiency, which in turn increases the fatigue of respiratory muscles. Early recognition of respiratory decline and symptomatic intervention, including non-invasive ventilation can significantly enhance both quality of life and life expectancy in ALS. Patients with respiratory failure should be advised to consider an advance directive to avoid emergency mechanical ventilation.
    Item Type
    Article
    Language
    en
    ISSN
    1432-1459
    ae974a485f413a2113503eed53cd6c53
    10.1007/s00415-010-5830-y
    Scopus Count
    Collections
    Beaumont Hospital

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