Non-invasive ventilation commonly used in ALS

A study of 1458 patients with amyotrophic lateral sclerosis (ALS) has found that non-invasive positive pressure ventilators (NIPPV) are used more than 7-times more often than invasive ventilation. Patients of lower income were less likely to use NIPPV, investigators Noah Lechtzin and colleagues report.The researchers, from Johns Hopkins University School of Medicine in Baltimore, Maryland, USA, conducted a cross-sectional study of 1458 patients in the ALS Patient Care Database. They found that NIPPV was used in 15.6% of cases and mechanical ventilation in 2.1%. "Patients who used NIPPV were significantly more likely to be male and have higher income than those who did not," they write in the journal ALS and other motor neuron disorders. "They were also more likely to have a gastrostomy tube, lower vital capacity, more severe disease, bulbar involvement and poorer general health status."The authors say that their findings are provocative, and need to be assessed in other ALS populations. "While observational studies have shown that [NIPPV] can improve survival, its effects on respiratory function and disease progression remain unclear," Lechtzin and colleagues write."Above all, patients should be informed about the option of NIPPV use and its potential benefits," they conclude, adding that it is also important that all patients are given an equal opportunity to use NIPPV.Reference...