Background: Deterioration of vital capacity (VC) in amyotrophic lateral sclerosis (ALS) signifies disease progression and indicates need for non-invasive ventilation. Weak facial muscles consequent to ALS, with resulting poor mouth seal, may interfere with the accuracy of VC measurements. Objectives: To determine whether different interfaces affect VC measurements in ALS patients and whether the interface yielding the largest VC produces an even higher VC when re-measured after one week (learning effect). To explore the relationship between optimal interface VC and sniff nasal pressure (SNIP), a measurement of global inspiratory muscle strength. Methods: Thirty-five patients (17 bulbar and 18 spinal ALS) were studied. Three interfaces (rigid-cylindrical, flanged, oronasal mask) were tested. One week after the first visit, VC was recorded using the optimal interface. SNIP recordings were also obtained. Results: In the bulbar ALS group, median (interquartile range) VC with the flanged mouthpiece was 8.4% (3.9–15.5) larger than with the cylindrical mouthpiece (p < 0.001). VC values with oronasal mask were intermediate to VC with the other two interfaces. In spinal ALS, flanged mouthpiece VC was 4.6% (2.3–7.5) larger than with oronasal mask (p < 0.0006). The latter was 4.5% (0.6–5.2) smaller than with the cylindrical mouthpiece (p = 0.002). In both groups, VC during the second visit was greater than during the first visit (p < 0.025). SNIPs were logarithmically related to VC values recorded with the flanged mouthpiece. Conclusion: A flanged mouthpiece yields the largest values of VC in patients with bulbar and spinal ALS.

Measuring vital capacity in amyotrophic lateral sclerosis : effects of interfaces and reproducibility / G.M. Pellegrino, G.F. Sferrazza Papa, S. Centanni, M. Corbo, D. Kvarnberg, M.J. Tobin, F. Laghi. - In: RESPIRATORY MEDICINE. - ISSN 0954-6111. - 176(2021), pp. 106277.1-106277.6. [10.1016/j.rmed.2020.106277]

Measuring vital capacity in amyotrophic lateral sclerosis : effects of interfaces and reproducibility

G.M. Pellegrino;G.F. Sferrazza Papa;S. Centanni;
2021

Abstract

Background: Deterioration of vital capacity (VC) in amyotrophic lateral sclerosis (ALS) signifies disease progression and indicates need for non-invasive ventilation. Weak facial muscles consequent to ALS, with resulting poor mouth seal, may interfere with the accuracy of VC measurements. Objectives: To determine whether different interfaces affect VC measurements in ALS patients and whether the interface yielding the largest VC produces an even higher VC when re-measured after one week (learning effect). To explore the relationship between optimal interface VC and sniff nasal pressure (SNIP), a measurement of global inspiratory muscle strength. Methods: Thirty-five patients (17 bulbar and 18 spinal ALS) were studied. Three interfaces (rigid-cylindrical, flanged, oronasal mask) were tested. One week after the first visit, VC was recorded using the optimal interface. SNIP recordings were also obtained. Results: In the bulbar ALS group, median (interquartile range) VC with the flanged mouthpiece was 8.4% (3.9–15.5) larger than with the cylindrical mouthpiece (p < 0.001). VC values with oronasal mask were intermediate to VC with the other two interfaces. In spinal ALS, flanged mouthpiece VC was 4.6% (2.3–7.5) larger than with oronasal mask (p < 0.0006). The latter was 4.5% (0.6–5.2) smaller than with the cylindrical mouthpiece (p = 0.002). In both groups, VC during the second visit was greater than during the first visit (p < 0.025). SNIPs were logarithmically related to VC values recorded with the flanged mouthpiece. Conclusion: A flanged mouthpiece yields the largest values of VC in patients with bulbar and spinal ALS.
Amyotrophic lateral sclerosis; Non-invasive ventilation; Oral interfaces; Respiratory function; Respiratory function test; Respiratory muscle weakness
Settore MED/10 - Malattie dell'Apparato Respiratorio
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/2434/877533
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