Вопросы ранней диагностики и своевременной коррекции дыхательных нарушений при боковом амиотрофическом склерозе (обзор литературы)

Abstract

Amyotrophic lateral sclerosis (ALS) is a rare severe progressive neurodegenerative disease with upper and lower motor neuron lesions, manifested by weakness of somatic muscle tissue with disorder of vital functions and leading to early disability and fatal outcome of patients. Regardless of the disease form, patients with ALS experience breathing and swallowing disorders. Hypercapnic respiratory failure (HRF) most commonly develop in patients as a consequence of respiratory muscle weakness. Instrumental diagnostic methods are currently used along with the assessment of the HRF clinical picture in ALS. Pulse oximetry and spirometry are the basic means of assessing the respiratory system function. Cardio-respiratory monitoring and arterial blood gas test play an auxiliary role in the diagnosis. To correct respiratory disorders, respiratory support is used with the help of artificial ventilation devices connected through various masks (non-invasive) or through a tracheostomy (invasive). In recent years, it has been proven that early diagnosis and correction of respiratory disorders contribute to prolonging the life of patients with ALS and improving its quality. The review presents the main development mechanisms of respiratory disorders in ALS, clinical and instrumental methods of their diagnosis, methods of correction, as well as criteria for the start of respiratory support. KEYWORDS: amyotrophic lateral sclerosis, respiratory disorders, lung ventilation, pulmonary support, neurodegeneration, NIV, ALV. FOR CITATION: Ermilov E.A., Isaeva N.V. Issues concerning early diagnosis and timely correction of respiratory disorders in amyotrophic lateral sclerosis (literature review). Russian Medical Inquiry. 2023;7(8). (in Russ.). DOI: 10.32364/2587-6821-2023-7-8-4.