• Respiratory care · Sep 2013

    Multicenter Study

    Absence of airway secretion accumulation predicts tolerance of noninvasive ventilation in subjects with amyotrophic lateral sclerosis.

    • Nadia Vandenberghe, Anne-Evelyne Vallet, Thierry Petitjean, Pierre Le Cam, Stéphane Peysson, Claude Guérin, Frédéric Dailler, Sylvie Jay, Vincent Cadiergue, Françoise Bouhour, Isabelle Court-Fortune, Jean-Philippe Camdessanche, Jean-Christophe Antoine, François Philit, Pascal Beuret, Sylvie Bin-Dorel, Christophe Vial, and Emmanuel Broussolle.
    • Service d'Electroneuromyographie et Service de Neurologie C, Centre Sclérose Latérale Amyotrophique de Lyon, Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Lyon, France.
    • Respir Care. 2013 Sep 1;58(9):1424-32.

    ObjectiveTo assess factors that predict good tolerance of noninvasive ventilation (NIV), in order to improve survival and quality of life in subjects with amyotrophic lateral sclerosis.MethodsWe conducted a prospective study in subjects with amyotrophic lateral sclerosis and requiring NIV. The primary end point was NIV tolerance at 1 month. Subjects, several of whom failed to complete the study, were classified as "tolerant" or "poorly tolerant," according to the number of hours of NIV use (more or less than 4 h per night, respectively).ResultsEighty-one subjects, 73 of whom also attended the 1-month follow-up visit, participated over 34 months. NIV tolerance after the first day of utilization predicted tolerance at 1 month (77.6% and 75.3% of subjects, respectively). Multivariate analysis disclosed 3 factors predicting good NIV tolerance: absence of airway secretions accumulation prior to NIV onset (odds ratio 11.5); normal bulbar function at initiation of NIV (odds ratio 8.5); and older age (weakly significant, odds ratio 1.1).ConclusionOur study reveals 3 factors that are predictive of good NIV tolerance, in particular the absence of airway secretion accumulation, which should prompt NIV initiation before its appearance.

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