Preoperative parameters and their prognostic value in amyotrophic lateral sclerosis patients undergoing implantation of a diaphragm pacing stimulation system
Introduction: Amyotrophic lateral sclerosis (ALS) is a progressive neuromuscular disease with devastating and fatal respiratory complications. Diaphragm pacing stimulation (DPS) is a treatment option in diaphragm insufficient ALS patients. Ventilatory insufficiency depending on diaphragmatic failure...
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Medknow Publications
2017-01-01
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| Series: | Annals of Indian Academy of Neurology |
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| Online Access: | http://www.annalsofian.org/article.asp?issn=0972-2327;year=2017;volume=20;issue=1;spage=51;epage=54;aulast=Sanli |
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| author | Aydin Sanli Ihsan Şükrü Şengün Volkan Karaçam Aylin Özgen Alpaydın Kemal Can Tertemiz Sevgi Özalevli Bahar Ağaoğlu Şanlı Alper Kaya Nezih Özdemir |
| author_facet | Aydin Sanli Ihsan Şükrü Şengün Volkan Karaçam Aylin Özgen Alpaydın Kemal Can Tertemiz Sevgi Özalevli Bahar Ağaoğlu Şanlı Alper Kaya Nezih Özdemir |
| author_sort | Aydin Sanli |
| collection | DOAJ |
| description | Introduction: Amyotrophic lateral sclerosis (ALS) is a progressive neuromuscular disease with devastating and fatal respiratory complications. Diaphragm pacing stimulation (DPS) is a treatment option in diaphragm insufficient ALS patients. Ventilatory insufficiency depending on diaphragmatic failure is treated by the present study aimed to investigate prognostic value of preoperative clinical and functional characteristics of ALS patients undergoing implantation of a DPS system and to determine appropriate indications for the DPS system. Methods: The study included 34 ALS patients implanted with DPS system. All patients underwent multidisciplinary and laboratory evaluations before the surgery. The laboratory examinations included pulmonary function tests and arterial blood gas analysis. Survival rates were recorded in a 2-year follow-up after the surgery. Results: Twenty-eight of 34 patients with ALS survived after a 2-year follow-up. These patients were younger than those who died and had the disease for a longer time; however, the differences were not significant. Both right and left hemidiaghragms were thicker in the survived patients (P < 0.0001 for each). Pulmonary function tests revealed no significant differences between the patients who survived. Arterial blood gas analysis demonstrated lower partial pressure of carbon dioxide in the survived patients (P = 0.025). Conclusions: DPS implantation was more efficacious in ALS patients with mild respiratory failure and thicker diaphragm. Predictors of long-term effectiveness of DPS system are needed to be addressed by large-scale studies. |
| first_indexed | 2024-12-23T23:19:02Z |
| format | Article |
| id | doaj.art-488b4efe89ea46b88949db17d151ebbf |
| institution | Directory Open Access Journal |
| issn | 0972-2327 1998-3549 |
| language | English |
| last_indexed | 2024-12-23T23:19:02Z |
| publishDate | 2017-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Annals of Indian Academy of Neurology |
| spelling | doaj.art-488b4efe89ea46b88949db17d151ebbf2022-12-21T17:26:23ZengWolters Kluwer Medknow PublicationsAnnals of Indian Academy of Neurology0972-23271998-35492017-01-01201515410.4103/0972-2327.192388Preoperative parameters and their prognostic value in amyotrophic lateral sclerosis patients undergoing implantation of a diaphragm pacing stimulation systemAydin SanliIhsan Şükrü ŞengünVolkan KaraçamAylin Özgen AlpaydınKemal Can TertemizSevgi ÖzalevliBahar Ağaoğlu ŞanlıAlper KayaNezih ÖzdemirIntroduction: Amyotrophic lateral sclerosis (ALS) is a progressive neuromuscular disease with devastating and fatal respiratory complications. Diaphragm pacing stimulation (DPS) is a treatment option in diaphragm insufficient ALS patients. Ventilatory insufficiency depending on diaphragmatic failure is treated by the present study aimed to investigate prognostic value of preoperative clinical and functional characteristics of ALS patients undergoing implantation of a DPS system and to determine appropriate indications for the DPS system. Methods: The study included 34 ALS patients implanted with DPS system. All patients underwent multidisciplinary and laboratory evaluations before the surgery. The laboratory examinations included pulmonary function tests and arterial blood gas analysis. Survival rates were recorded in a 2-year follow-up after the surgery. Results: Twenty-eight of 34 patients with ALS survived after a 2-year follow-up. These patients were younger than those who died and had the disease for a longer time; however, the differences were not significant. Both right and left hemidiaghragms were thicker in the survived patients (P < 0.0001 for each). Pulmonary function tests revealed no significant differences between the patients who survived. Arterial blood gas analysis demonstrated lower partial pressure of carbon dioxide in the survived patients (P = 0.025). Conclusions: DPS implantation was more efficacious in ALS patients with mild respiratory failure and thicker diaphragm. Predictors of long-term effectiveness of DPS system are needed to be addressed by large-scale studies.http://www.annalsofian.org/article.asp?issn=0972-2327;year=2017;volume=20;issue=1;spage=51;epage=54;aulast=SanliAmyotrophic lateral sclerosisdiaphragm pacingrespiratory failure |
| spellingShingle | Aydin Sanli Ihsan Şükrü Şengün Volkan Karaçam Aylin Özgen Alpaydın Kemal Can Tertemiz Sevgi Özalevli Bahar Ağaoğlu Şanlı Alper Kaya Nezih Özdemir Preoperative parameters and their prognostic value in amyotrophic lateral sclerosis patients undergoing implantation of a diaphragm pacing stimulation system Annals of Indian Academy of Neurology Amyotrophic lateral sclerosis diaphragm pacing respiratory failure |
| title | Preoperative parameters and their prognostic value in amyotrophic lateral sclerosis patients undergoing implantation of a diaphragm pacing stimulation system |
| title_full | Preoperative parameters and their prognostic value in amyotrophic lateral sclerosis patients undergoing implantation of a diaphragm pacing stimulation system |
| title_fullStr | Preoperative parameters and their prognostic value in amyotrophic lateral sclerosis patients undergoing implantation of a diaphragm pacing stimulation system |
| title_full_unstemmed | Preoperative parameters and their prognostic value in amyotrophic lateral sclerosis patients undergoing implantation of a diaphragm pacing stimulation system |
| title_short | Preoperative parameters and their prognostic value in amyotrophic lateral sclerosis patients undergoing implantation of a diaphragm pacing stimulation system |
| title_sort | preoperative parameters and their prognostic value in amyotrophic lateral sclerosis patients undergoing implantation of a diaphragm pacing stimulation system |
| topic | Amyotrophic lateral sclerosis diaphragm pacing respiratory failure |
| url | http://www.annalsofian.org/article.asp?issn=0972-2327;year=2017;volume=20;issue=1;spage=51;epage=54;aulast=Sanli |
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