Home-Based Adaptation to Night-Time Non-Invasive Ventilation in Patients with Amyotrophic Lateral Sclerosis: A Randomized Controlled Trial.
ALS
MND
NIV
amyotrophic lateral sclerosis
homecare
motor neuron disease
non-invasive ventilation
Journal
Journal of clinical medicine
ISSN: 2077-0383
Titre abrégé: J Clin Med
Pays: Switzerland
ID NLM: 101606588
Informations de publication
Date de publication:
02 Jun 2022
02 Jun 2022
Historique:
received:
26
04
2022
revised:
25
05
2022
accepted:
30
05
2022
entrez:
10
6
2022
pubmed:
11
6
2022
medline:
11
6
2022
Statut:
epublish
Résumé
Initiation to Non-Invasive Ventilation (NIV) in amyotrophic lateral sclerosis (ALS) can be implemented in an inpatient or outpatient setting. We aimed to evaluate the efficacy of adaptation (the number of needed sessions) to home-based NIV compared to an outpatient one in ALS in terms of arterial carbon dioxide (PaCO2) improvement. NIV acceptance (mean use of ≥5 h NIV per night for three consecutive nights during the adaptation trial), adherence (night-time NIV usage for ≥150 h/month), quality of life (QoL), and caregiver burden were secondary outcomes. A total of 66 ALS patients with indications for NIV were involved in this randomized controlled trial (RCT): 34 underwent NIV initiation at home (home adaptation, HA) and 32 at multiple outpatient visits (outpatient adaptation, OA). Respiratory function tests were performed at baseline (the time of starting the NIV, T0) together with blood gas analysis, which was repeated at the end of adaptation (T1) and 2 (T2) and 6 (T3) months after T1. NIV adherence was measured at T2 and T3. Overnight cardiorespiratory polygraphy, Short Form Health Survey (SF-36), Caregiver Burden Inventory (CBI), Caregiver Burden Scale (CBS), and Zarit Burden Interview (ZBI) were performed at T0, T2, and T3. Fifty-eight participants completed the study. No differences were found between groups in PaCO2 at T1 ( In ALS, adaptation to NIV in the patient's home is as effective as that performed in an outpatient setting regarding PaCO2, acceptance, and adherence, which emphasizes the need for further studies to understand the role of the environment concerning NIV adherence.
Sections du résumé
BACKGROUND
BACKGROUND
Initiation to Non-Invasive Ventilation (NIV) in amyotrophic lateral sclerosis (ALS) can be implemented in an inpatient or outpatient setting.
AIMS
OBJECTIVE
We aimed to evaluate the efficacy of adaptation (the number of needed sessions) to home-based NIV compared to an outpatient one in ALS in terms of arterial carbon dioxide (PaCO2) improvement. NIV acceptance (mean use of ≥5 h NIV per night for three consecutive nights during the adaptation trial), adherence (night-time NIV usage for ≥150 h/month), quality of life (QoL), and caregiver burden were secondary outcomes.
METHODS
METHODS
A total of 66 ALS patients with indications for NIV were involved in this randomized controlled trial (RCT): 34 underwent NIV initiation at home (home adaptation, HA) and 32 at multiple outpatient visits (outpatient adaptation, OA). Respiratory function tests were performed at baseline (the time of starting the NIV, T0) together with blood gas analysis, which was repeated at the end of adaptation (T1) and 2 (T2) and 6 (T3) months after T1. NIV adherence was measured at T2 and T3. Overnight cardiorespiratory polygraphy, Short Form Health Survey (SF-36), Caregiver Burden Inventory (CBI), Caregiver Burden Scale (CBS), and Zarit Burden Interview (ZBI) were performed at T0, T2, and T3.
RESULTS
RESULTS
Fifty-eight participants completed the study. No differences were found between groups in PaCO2 at T1 (
CONCLUSIONS
CONCLUSIONS
In ALS, adaptation to NIV in the patient's home is as effective as that performed in an outpatient setting regarding PaCO2, acceptance, and adherence, which emphasizes the need for further studies to understand the role of the environment concerning NIV adherence.
Identifiants
pubmed: 35683562
pii: jcm11113178
doi: 10.3390/jcm11113178
pmc: PMC9181816
pii:
doi:
Types de publication
Journal Article
Langues
eng
Références
Chest. 2020 Dec;158(6):2493-2501
pubmed: 32682770
Ther Adv Neurol Disord. 2019 Jun 21;12:1756286419857040
pubmed: 31258624
Br J Health Psychol. 2015 May;20(2):341-59
pubmed: 24796270
Neurology. 2005 May 24;64(10):1780-2
pubmed: 15911811
J Neurol Sci. 1999 Oct 31;169(1-2):13-21
pubmed: 10540002
Health Psychol Behav Med. 2013 Jan 1;1(1):47-58
pubmed: 25264500
Eur J Phys Rehabil Med. 2017 Dec;53(6):892-899
pubmed: 28382811
Can Respir J. 2016;2016:6547180
pubmed: 27445559
Respirology. 2019 Jun;24(6):521-530
pubmed: 30912216
Arch Bronconeumol (Engl Ed). 2019 May;55(5):246-251
pubmed: 30598235
Neurol Sci. 2017 Jun;38(6):1059-1068
pubmed: 28332040
Sleep. 1991 Dec;14(6):540-5
pubmed: 1798888
Respir Med. 2021 Jan;176:106277
pubmed: 33310203
Chest. 2002 Jul;122(1):92-8
pubmed: 12114343
Thorax. 2012 Jun;67(6):546-52
pubmed: 20971982
BMJ. 1992 Jul 18;305(6846):160-4
pubmed: 1285753
J Clin Sleep Med. 2012 Oct 15;8(5):597-619
pubmed: 23066376
Amyotroph Lateral Scler Frontotemporal Degener. 2014 Jun;15(3-4):180-4
pubmed: 24555916
Eur J Neurol. 2012 Mar;19(3):360-75
pubmed: 21914052
Respir Med. 2008 Nov;102(11):1528-35
pubmed: 18774702
Amyotroph Lateral Scler Frontotemporal Degener. 2015;16(5-6):291-2
pubmed: 26121170
Psychol Health Med. 2010 Dec;15(6):685-93
pubmed: 21154021
J Neurosci Nurs. 2014 Oct;46(5):E25-32
pubmed: 25188688
BMJ Support Palliat Care. 2014 Mar;4(1):50-6
pubmed: 24644771
Amyotroph Lateral Scler. 2006 Dec;7(4):195-200
pubmed: 17127557
Amyotroph Lateral Scler Frontotemporal Degener. 2021;22(sup1):33-39
pubmed: 34348536
J Neurol Sci. 1999 Mar 15;164(1):82-8
pubmed: 10385053
Int Psychogeriatr. 2011 Jun;23(5):797-805
pubmed: 21205379
Eur Respir J. 2010 Feb;35(2):353-60
pubmed: 19741023
Lancet Neurol. 2006 Feb;5(2):140-7
pubmed: 16426990
J Neurol Neurosurg Psychiatry. 2010 Nov;81(11):1238-42
pubmed: 20826878
Eur Respir J. 2002 Mar;19(3):434-8
pubmed: 11936519
Pulmonology. 2019 Jul - Aug;25(4):223-235
pubmed: 30509855
Sleep. 1999 Aug 1;22(5):667-89
pubmed: 10450601
J Neurol. 2016 Dec;263(12):2456-2461
pubmed: 27638636
J Thorac Dis. 2019 Mar;11(3):795-804
pubmed: 31019767
Amyotroph Lateral Scler Frontotemporal Degener. 2018 Aug;19(5-6):331-341
pubmed: 29661084
Respir Med. 2007 Jun;101(6):1177-82
pubmed: 17188485
Gerontologist. 1989 Dec;29(6):798-803
pubmed: 2516000
Respir Med. 2014 Sep;108(9):1387-95
pubmed: 25081652
Thorax. 2020 Mar;75(3):244-252
pubmed: 31484786
Amyotroph Lateral Scler Frontotemporal Degener. 2018 Feb;19(1-2):134-142
pubmed: 28891333
Eur Respir J. 1993 Mar;6 Suppl 16:5-40
pubmed: 24576915
Eur J Neurol. 2018 Mar;25(3):556-e33
pubmed: 29266547
Can J Neurol Sci. 2018 Jul;45(4):445-450
pubmed: 29871704
Respir Care. 2018 May;63(5):601-608
pubmed: 29692352
Rinsho Shinkeigaku. 2003 Jul;43(7):385-91
pubmed: 14582363
PLoS One. 2011 Mar 30;6(3):e17893
pubmed: 21479202