远程肺功能测试允许在患有ALS的人群中早期识别对非侵入性通风的需求
Andrew Geronimo1, Zachary Simmons2
1Departments of Neurology and Neurosurgery, Penn State College of Medicine, Hershey, PA 17033, United States of America.
Journal of the neurological sciences
|March 24, 2024
概括
每周远程肺功能测试 (rPFT) 对于肌缩侧面硬化症 (ALS) 患者,可以提前启动非侵入性通风 (NIV). 这种基于家庭的方法比标准的季度评估更早地确定了NIV的需求,特别是对于快速衰退的患者.
科学领域:
- 神经学 神经学
- 肺部病理学 肺部病理学
- 医疗技术 医疗技术 医学技术
背景情况:
- 传统上,肌缩侧面硬化症 (ALS) 的管理依赖于季度呼吸评估.
- 这种时间表可能会延迟呼吸不足的鉴定和非侵入性通风 (NIV) 的最佳启动.
- 远程肺功能测试 (rPFT) 为更频繁的家庭监测提供了一个解决方案.
研究的目的:
- 为了比较每周rPFT的临床益处与ALS患者的标准季度临床评估.
- 量化早期的NIV需求识别,提前通知的持续时间,以及利益的预测因素.
- 评估rPFT对ALS中NIV启动时间的影响.
主要方法:
- 39名患有ALS的参与者通过远程医疗接受了每周一次,在家进行rPFT的培训.
- 患者自行每周进行一次rPFT治疗一年,并通过远程监控数据.
- 结果包括确定预测的50%以下的强迫生命能力 (FVC) 和随后的NIV处方.
主要成果:
- 17名参与者显示远程测量FVC低于预测的50%.
- 对于其中的13个,NIV需要的预告时间中位数为53天 (范围:-61至294天).
- 六名参与者根据远程测试结果启动了NIV,在面对面评估表明需要之前.
结论:
- 与标准护理相比,每周的RPFT可以更早地识别ALS患者的NIV需求.
- 观察到的最大益处是在基线低呼吸功能和快速下降的患者身上.
- rPFT具有显著的潜力,可以改善ALS的临床管理和临床试验进行.
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