ALS patients on TPPV: totally locked-in state, neurologic findings and ethical implications.
retrospective_cohort · Level III
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Abstract
Seventy patients with ALS using tracheostomy positive pressure ventilation (TPPV) were evaluated for impaired communication. Severely impaired communication is divided into the totally locked-in state (TLS) and the minimal communication state (MCS). TLS occurred in 8 of 70 (11.4%). In the 33 patients on TPPV for more than 5 years, TLS developed in 6 (18.2%) and MCS in 11 (33.1%). Respiratory management for ALS allows long-term survival if mechanical ventilation is used.
Medical subject headings
- Amyotrophic Lateral Sclerosis
- Communication Disorders
- Ethics, Clinical
- Positive-Pressure Respiration
- Quadriplegia