Clinical-demographic characteristics and ventilatory requirements of subjects with amyotrophic lateral sclerosis in a weaning and rehabilitation center

A descriptive study

Abstract

Objective: To describe the clinical-demographic characteristics and  ventilatory requirements in subjects with amyotrophic lateral sclerosis (ALS) admitted to a weaning and rehabilitation center (WRC). The secondary objectives were to analyze survival time within the WRC and describe the condition at discharge.

Materials and methods: An observational, cross-sectional, and retrospective study was conducted. Subjects over 18 years of age admitted between January 1, 2016, and March 30, 2023, were included. Clinical-demographic characteristics were described, and a time-based survival analysis was performed.

Results: Thirty-three subjects were included. Of these, 84.8 % had a tracheostomy and invasive mechanical ventilation (IMV), while 5 had non-invasive mechanical ventilation (NIMV). Four subjects achieved partial weaning, and no subject with NIMV required an artificial airway. Twelve subjects (41.4 %) achieved leak speech, and 9 (27.3 %) received therapeutic feeding. The length of stay was 174 days (57-319), and the median survival time was 254 days (95 % CI 89-344).

Conclusion: Subjects with ALS admitted to the CDVMR were mostly tracheostomized, required IMV, and were bedridden upon admission. Additionally, they had prolonged stays, with goals that generally did not focus on weaning from mechanical ventilation. However, it was possible to work on other aspects that improve their daily life, such as phonation with leak ventilation and recreational oral feeding.