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The importance of a respiratory therapist in the ALS clinic

机译:呼吸治疗师在ALS诊所中的重要性

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摘要

Although multidisciplinary amyotrophic lateral sclerosis (ALS) clinics are widely endorsed, there is limited evidence they improve outcome.We retrospectively assessed use of non-invasive ventilation in 37 ALS patients seen before and 40 patients seen after the addition of a respiratory therapist to our clinic. Patients undergoing respiratory therapy were more likely to try non-invasive ventilation (odds ratio 4.01; 95% confidence interval 1.42-11.35) and more likely to use it for at least four hours per night (odds ratio 9.5, 95% confidence interval 2.32-38.88). Median survival following non-invasive ventilation institution was 10 months for those using it four or more hours per night and five months for those who refused it or who used it for less than four hours per night (p<0.03). We conclude that adding a respiratory therapist to our multidisciplinary ALS clinic led to an increase in the percentage of patients willing to try BiNIV as well as to use it more than four hours per night, and confirm as in prior studies that such use leads to prolonged survival.
机译:尽管多学科的肌萎缩性侧索硬化症(ALS)诊所得到广泛认可,但证据表明它们改善了结局。我们回顾性评估了在我们的诊所新增呼吸治疗师之前和之后发现的37例ALS患者和40例患者之后的无创通气使用。接受呼吸治疗的患者更有可能尝试无创通气(赔率4.01; 95%置信区间1.42-11.35),更可能每晚使用至少4小时(赔率9.5,95%置信区间2.32- 38.88)。使用无创通气机构后,每晚使用四个或更多小时的患者中位生存期为10个月,拒绝使用或每晚使用少于4小时的患者为5个月(p <0.03)。我们得出的结论是,在我们的多学科ALS诊所中增加呼吸治疗师会导致愿意尝试BiNIV以及每晚使用超过4个小时的患者比例增加,并且如以前的研究中证实,这种使用会导致治疗时间延长生存。

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