[Medical intensive care aspects in treatment of amyotrophic lateral sclerosis]

Whereas it would be preferable to inform patients with amyotrophic lateral sclerosis (ALS) as early as possible about the possibilities of ventilatory support, not all of them are able to bear the required thorough information on the consequences of the diagnosis. The procedure therefore has to be individualized. Questionnaire studies have revealed, that in general patients hold the opinion that they themselves should decide, whether or not artificial ventilation should be applied. The non-invasive artificial home ventilation has led to advances in the management of patients with ALS, as a longer period of survival with a higher level of quality of life can be achieved. On the other hand, according to the author's opinion. Invasive artificial ventilation can not be the primary goal of medical support in the context of the prognosis (progressive differentiation). Much more this should focus on the appropriate steps to warrant increase of period of survival under conditions of at least minimal quality of life. Other opinions however have to be respected. Appropriate procedures for prevention and therapy of respiratory dysfunctions are discussed.