異なった人工呼吸器を用いた筋萎縮性側索硬化症の3例の転帰

筋萎縮性側索硬化症患者の人工呼吸管理の見通し

抄録

The prognosis of patients with ALS depends on the existence of ventilatory failure. To manage this, invasive intermittent positive pressure ventilation (invasive IPPV) has been the only treatment. This type of treatment, however, may spoil the quality of life of the patients, and they and their families may not be willing to accept it. Recently, noninvasive intermittent positive pressure ventilation including bilevel positive airway pressure ventilator (BiPAP). which is less costly, has become widely used. In this study, we applied BiPAP to two patients (one bulbar type and the other non-bulbar type) and invasive IPPV to one patient (bulbar type). The patient with non-bulbar ALS treated with BiPAP seemed to be more comfortable in speech and feeding than the patient with invasive IPPV. However, this did not apply to the patient with bulbar ALS treated with BiPAP. Further investigations are needed to elucidate the criteria of introducing BiPAP to patients with ALS.