筋萎縮性側索硬化症患者に非侵襲的換気療法は推奨されるか

抄録

Recent advances in neurology have been remarkable, and it has become possible to control diseases and symptoms that can be cured. On the other hand, there are still a wide variety of problems faced by intractable neurological diseases, and among them, there are also various problems related to palliative care. Amyotrophic lateral sclerosis (ALS) is an incurable disease that causes motor neuron damage, and as it progresses, breathing problems occur. Respiratory support therapies include noninvasive ventilation (NIV) and tracheostomy invasive ventilation (TIV). Past reports suggest that NIV therapy not only improves various symptoms caused by respiratory disorders, but also improves and maintains the quality of life during the non–TIV period, improves the quality of sleep, and suppresses the decline in respiratory function. On the other hand, in advanced stages, it is difficult to deal with upper airway obstruction due to saliva aspiration, tongue base subsidence, etc., and respiratory symptoms may not be alleviated with NIV alone. In addition to respiratory physical therapy, NIV therapy has been used to alleviate respiratory symptoms, prolong survival time, and improve quality of life (QOL). Further research is needed to assess the extent to which this contributes to QOL. In this symposium, we will outline the process of examining how NIV therapy contributes to QOL in ALS patients from the perspective of palliative care, as well as the concerns that patients have difficulty expressing in words.