36 of 50 With ALS Tolerate Noninvasive Ventilation

Neither age nor gender nor duration of disease are good predictors of whether a person with ALS will tolerate noninvasive ventilation (NIV) — air delivered under pressure through the nose or mouth — says a new study from the University of Michigan.

It says, however, that when ALS-related weakness starts in an arm or leg (limb-onset), rather than the mouth or throat (bulbar-onset), NIV tolerance is more likely.

The investigators, who published their findings in the December issue of Muscle & Nerve, analyzed data from 50 people with ALS between 2000 and 2003. They found that 36 (72 percent) were able to use NIV for at least four hours a night, while 14 (28 percent) were not.

They controlled patients’ excess saliva with medication and nasal congestion with steroid sprays; prescribed heated, humidified air, delivered through small, nasal interfaces (Nasal-Aire brand); and made small, weekly air pressure increases as needed.