| Autor: |
Martina Garofalo, Marco Monelli, Alessandro Marchioni, Mandrioli Jessica, Riccardo Fantini, Roberto Tonelli, Dario Andrisani, Clini Enrico, Zona Stefano, Antonia Sdanganelli, Ivana Castaniere |
| Rok vydání: |
2017 |
| Předmět: |
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| Zdroj: |
Noninvasive Ventilatory Support. |
| DOI: |
10.1183/1393003.congress-2017.pa2187 |
| Popis: |
Background and aims: Ultrasound (US) measures have been shown to provide a valid assessment of diaphragmatic function without any patient’s collaboration. We thus aimed at evaluating the time course of diaphragmatic US assessment and its role to predict the clinical outcome in patients with Amyotrophic Lateral Sclerosis (ALS). Methods: Fifty-six outpatients with ALS were referred at our unit and consecutively enrolled. Forced vital capacity (FVC), sniff pressure (SNIP), arterial blood gases, and US of the diaphragm [to measure thickness-Tdi both at total lung (TLC) and tidal (TV) volume, and their ratio (ΔTmax)] were recorded every two months up to 2-year. As it has been reported that ΔTmax=0.75 provides a 75% sensitivity and a 85% specificity in predicting a FVC value lower than 50% of predicted, we consider pathological a ΔTmax value higher than 0.75. Existing correlation among these measures and the clinical outcome (NIV onset and mortality) were tested. Results: ΔTmax >0.75 showed increased risk for NIV onset (log-rank test 0.03) and mortality (HR 6.11 95%CI [1.78-15.8, log-rank test 0.001]) compared with lower values in patients with ALS. Abnormal FVC and SNIP were also associated to the increased risk of death. A significant difference in blood carbon dioxide levels (CO2) and occurrence of nocturnal hypoventilation was found in patients with ΔTmax >0.75 compared with Conclusion: Non-volitional diaphragmatic assessment by US-ΔTmax may predict over time the risk of NIV onset and mortality in patients with ALS. |
| Databáze: |
OpenAIRE |
| Externí odkaz: |
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