A comparison of maximal inspiratory pressure and forced vital capacity as potential criteria for initiating non-invasive ventilation in amyotrophic lateral sclerosis

Amyotroph Lateral Scler. 2007 Apr;8(2):106-11. doi: 10.1080/17482960601030188.

Abstract

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 H(2)O 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 H(2)O. 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 H(2)O allows US clinicians to obtain non-invasive ventilatory support for patients earlier than if using the FVC criterion alone.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Amyotrophic Lateral Sclerosis / diagnosis*
  • Amyotrophic Lateral Sclerosis / therapy*
  • Female
  • Humans
  • Inspiratory Capacity*
  • Male
  • Maximal Voluntary Ventilation
  • Middle Aged
  • Patient Selection*
  • Prognosis
  • Reproducibility of Results
  • Respiration, Artificial / methods*
  • Retrospective Studies
  • Sensitivity and Specificity
  • Vital Capacity*