Home > Riviste > European Journal of Physical and Rehabilitation Medicine > Fascicoli precedenti > European Journal of Physical and Rehabilitation Medicine 2017 December;53(6) > European Journal of Physical and Rehabilitation Medicine 2017 December;53(6):892-9

ULTIMO FASCICOLO
 

JOURNAL TOOLS

eTOC
Per abbonarsi
Sottometti un articolo
Segnala alla tua biblioteca
 

ARTICLE TOOLS

Publication history
Estratti
Permessi
Per citare questo articolo

 

ORIGINAL ARTICLE   Freefree

European Journal of Physical and Rehabilitation Medicine 2017 December;53(6):892-9

DOI: 10.23736/S1973-9087.17.04511-7

Copyright © 2017 EDIZIONI MINERVA MEDICA

lingua: Inglese

Early initiation of night-time NIV in an outpatient setting: a randomized non-inferiority study in ALS patients

Enrica BERTELLA 1 , Paolo BANFI 2, Mara PANERONI 1, Silvia GRILLI 2, Luca BIANCHI 1, Eleonora VOLPATO 2, Michele VITACCA 1

1 Division of Respiratory Rehabilitation, Istituti Clinici Scientifici Maugeri, IRCCS, Lumezzane, Brescia, Italy; 2 Don Gnocchi Foundation, S. Maria Nascente Institute for Research and Care, Milan, Italy


PDF


BACKGROUND: In patients with amyotrophic lateral sclerosis (ALS), non-invasive ventilation (NIV) is usually initiated in an in-hospital regime.
AIM: We investigated if NIV initiated in an outpatient setting can be as effective in terms of patients’ acceptance/adherence. We also evaluated factors predicting NIV acceptance and adherence and disease progression.
DESIGN: Prospective randomized study.
SETTING: Outpatient versus inpatient rehabilitation.
POPULATION: ALS patients.
METHODS: ALS patients were randomized to two groups for NIV initiation: outpatients versus inpatients. At baseline (T0), end of NIV trial program (T1) and after 3 months from T1 (T2), respiratory function tests, blood gas analysis, and sleep study were performed. At T1, we assessed: NIV acceptance (>4 h/night), and dyspnea symptoms (day/night) by Visual analogue scale (VAS), staff and patients’ experience (how difficult NIV was to accept, how difficult ventilator was to manage, satisfaction); at T2: NIV adherence (>120 h/month) and patients’ experience.
RESULTS: Fifty patients participated. There were no differences in acceptance failure (P=0.733) or adherence failure (P=0.529). At T1, outpatients had longer hours of nocturnal ventilation (P<0.02), at T2 this was similar (P=0.34). Female gender and spinal onset of the disease were predictors for NIV acceptance/adherence failure. There were no between-group differences in progression of respiratory impairment, symptoms and sleep quality.
CONCLUSIONS: Early outpatient initiation of NIV in ALS is as effective as inpatient initiation.


KEY WORDS: Home care services - Amyotrophic lateral sclerosis - Noninvasive ventilation - Patient compliance

inizio pagina