Journal
AMYOTROPHIC LATERAL SCLEROSIS
Volume 8, Issue 2, Pages 106-111Publisher
TAYLOR & FRANCIS LTD
DOI: 10.1080/17482960601030188
Keywords
maximal inspiratory pressure; forced vital capacity; negative inspiratory force; amyotrophic lateral sclerosis; non-invasive ventilation
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Using a retrospective analysis of 161 patients with amyotrophic lateral sclerosis (ALS) from the Western ALS study group (WALS) database, the sensitivity of maximal inspiratory pressure (MIP) < - 60 cm H2O and forced vital capacity (FVC) < 50% as US Medicare thresholds for initiating non-invasive ventilation (NIV) were compared. Sixty-five per cent of patients at enrollment met the MIP criterion, compared with only 8% of patients who met the FVC criterion. There were no cases in which FVC < 50% antedated MIP < - 60 cm H2O. The longitudinal data showed that patients reached the MIP criterion 4 to 6.5 months earlier than the FVC criterion. For patients with clinical signs and symptoms needing treatment with NIV, a MIP < - 60 cm H2O allows US clinicians to obtain non-invasive ventilatory support for patients earlier than if using the FVC criterion alone.
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