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Application of different ventilator modes in patients with amyotrophic lateral sclerosis according to certain clinical situations: A Case Report.

Abstract Amyotrophic lateral sclerosis (ALS) is a rapidly progressing neurodegenerative disease that involves limb, axial, bulbar, and respiratory muscles. Fatigue and weakness of the respiratory muscles eventually induce respiratory insufficiency, which is one of the main causes of death in patients with ALS. In ALS patients with respiratory insufficiency, application of a ventilator is indispensable. Although there are various modes of ventilation, these modes are classified roughly into volume-controlled ventilation (VCV) and pressure-controlled ventilation (PCV). There have been several reports that VCV is preferable to PCV in neuromuscular disorder patients, such as ALS patients, but there is still debate on which ventilator mode is better.
PMID
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Authors

Mayor MeshTerms
Keywords
Journal Title medicine
Publication Year Start




PMID- 28834910
OWN - NLM
STAT- In-Process
DA  - 20170823
LR  - 20170823
IS  - 1536-5964 (Electronic)
IS  - 0025-7974 (Linking)
VI  - 96
IP  - 34
DP  - 2017 Aug
TI  - Application of different ventilator modes in patients with amyotrophic lateral
      sclerosis according to certain clinical situations: A Case Report.
PG  - e7899
LID - 10.1097/MD.0000000000007899 [doi]
AB  - RATIONALE: Amyotrophic lateral sclerosis (ALS) is a rapidly progressing
      neurodegenerative disease that involves limb, axial, bulbar, and respiratory
      muscles. Fatigue and weakness of the respiratory muscles eventually induce
      respiratory insufficiency, which is one of the main causes of death in patients
      with ALS. In ALS patients with respiratory insufficiency, application of a
      ventilator is indispensable. Although there are various modes of ventilation,
      these modes are classified roughly into volume-controlled ventilation (VCV) and
      pressure-controlled ventilation (PCV). There have been several reports that VCV
      is preferable to PCV in neuromuscular disorder patients, such as ALS patients,
      but there is still debate on which ventilator mode is better. PATIENT CONCERNS:
      Respiratory difficulty despite ventilator application. DIAGNOSIS: Three ALS
      patients with respiratory difficulty. INTERVENTION: Changing ventilator mode to
      improve symptoms of respiratory difficulty. OUTCOMES: Considering case 1 shows
      that the VCV mode may have an advantage in managing respiratory insufficiency of 
      patients in situations where the inner diameter of the airway decreases because
      of increased sputum. In contrast, cases 2 and 3, it is shown that changing to the
      PCV mode may be one of the treatment options if not enough tidal volume can be
      supplied to resolve respiratory insufficiency because of an increase in leakage
      volume. LESSONS: Therefore, in this study, through considering several cases of
      ALS patients whose clinical symptoms were improved by changing ventilation mode, 
      we tried to investigate the adequacy of each ventilation mode under certain
      clinical situations.
FAU - Park, Donghwi
AU  - Park D
AD  - Department of Rehabilitation Medicine, Daegu Fatima Hospital, Daegu, South Korea.
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Medicine (Baltimore)
JT  - Medicine
JID - 2985248R
EDAT- 2017/08/24 06:00
MHDA- 2017/08/24 06:00
CRDT- 2017/08/24 06:00
AID - 10.1097/MD.0000000000007899 [doi]
AID - 00005792-201708250-00047 [pii]
PST - ppublish
SO  - Medicine (Baltimore). 2017 Aug;96(34):e7899. doi: 10.1097/MD.0000000000007899.