Percutaneous endoscopic gastrostomy (PEG) and pulmonary function in patients with amyotrophic lateral sclerosis (ALS)

In ALS PEG tube placement attenuates malnutrition, secondary to bulbar dysphagia, and prevents other frequently fatal complications such as chocking and respiratory arrest. Respiratory insufficiency may be associated to the complications observed in this procedure. PEG tubes were placed in 26 patients (10M/16F) with dysphagia using the Gauderer technique, mild sedatives and local anaesthetics. Results are presented in absolute numbers; average; standard deviation: Age -26, 64,3±11,5; CVF% - 17, 64,5±35,6; PaCO2 - 26, 41,6±7,1; PaO2 - 26, 81,6±14,3. Four of the seventeen patients with spirometric evaluation had FVC inferior to 50%. Nine patients had chronic respiratory failure (CRF). Complications were identified in 2 patients (transient laryngeal spasm) and most likely secondary to bulbar involvement rather than pulmonary function.

Our experience shows PEG to be a safe procedure even in patients with advanced disease and reduced pulmonary capacity.