Diaphragmatic dysfunction at the first visit to a chest diseases outpatient clinic in 500 patients with amyotrophic lateral sclerosis

Introduction In this study, we aimed to evaluate diaphragmatic dysfunction (DD) by using a practical approach in patients with amyotrophic lateral sclerosis (ALS) at the first visit to a chest diseases outpatient clinic. Methods Patients with ALS seen in our outpatient clinic for the past 5 y and fo...

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Bibliographic Details
Published in:Muscle & nerve 2021-05, Vol.63 (5), p.683-689
Main Authors: Pihtili, Aylin, Bingol, Zuleyha, Durmus, Hacer, Parman, Yesim, Kiyan, Esen
Format: Article
Language:English
Subjects:
Amyotrophic lateral sclerosis
Apnea
Blood gas analysis
Chest
diaphragm
Evaluation
forced vital capacity
Gas analysis
Hypercapnia
Hypoxemia
Mechanical ventilation
Outpatient care facilities
Oximetry
Oxygen content
paradoxical abdominal movement
Signs and symptoms
Sleep
Sleep disorders
weakness
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Summary:Introduction In this study, we aimed to evaluate diaphragmatic dysfunction (DD) by using a practical approach in patients with amyotrophic lateral sclerosis (ALS) at the first visit to a chest diseases outpatient clinic. Methods Patients with ALS seen in our outpatient clinic for the past 5 y and followed up for at least 1 y, were retrospectively evaluated. Having at least one of the following three criteria was accepted as DD: (a) paradoxical abdominal movement (PAM), (b) sitting‐supine forced vital capacity (FVC) difference ≥ 20%, (c) sitting‐supine arterial oxygen saturation measured by pulse oximetry (SpO2) difference ≥ 4%. Respiratory symptoms, arterial blood gas analysis, sleep studies, noninvasive mechanical ventilation use, and mortality were recorded. Results Five‐hundred patients with ALS were included (female/male: 220/280, age: 58.9 ± 11.3 y). Of the patients, 22.8% had daytime hypercapnia. DD was observed in 55% of the patients (PAM in 112, sitting‐supine FVC difference ≥ 20% in 50, and sitting‐supine SpO2 difference ≥ 4% in 113 patients). Of the patients with DD, 31.6% (n = 87) had no respiratory symptoms, 46.4% had FVC > 70% and 33.5% had FVC
ISSN:0148-639X
1097-4598
DOI:10.1002/mus.27200