What to do with respiratory failure in the late stage of amyotrophic lateral sclerosis?

Written by Li Qiang
Intensive Care Unit
Updated on September 10, 2024
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Amyotrophic Lateral Sclerosis (ALS) is an irreversible disease, also known as motor neuron disease. Its motor function deteriorates progressively and irreversibly. Therefore, in the advanced stages, respiratory failure can only be managed with the help of a ventilator, which assists the patient's breathing mechanically. Consequently, patients typically require a tracheotomy in the late stages of the disease. Once connected to a ventilator via a tracheotomy, the ventilator becomes a permanent necessity. If at any point the ventilator is stopped, the patient would die due to lack of oxygen and the accumulation of carbon dioxide in the body. Therefore, they must wear the ventilator for life. Inevitably, this leads to respiratory-related complications, such as lung infections.

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Written by Liu Hong Mei
Neurology
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Is amyotrophic lateral sclerosis (ALS) contagious?

Amyotrophic lateral sclerosis (ALS), commonly known as Lou Gehrig's disease, is not contagious. It is a genetic disease associated with autosomal dominant inheritance and is not considered an infectious disease. The exact cause of ALS is still unclear. Commonly identified mechanisms include genetic factors, inflammatory agents, excitotoxic effects from amino acids, infections, autoimmune factors, exposure to toxins, and heavy metal poisoning from metals like lead, mercury, and aluminum. Other contributing factors may include a deficiency in nerve growth factors, mitochondrial dysfunction, and apoptosis. These factors may likely be involved in the development of ALS symptoms, but the disease is not communicable.

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Written by Zhang Hui
Neurology
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Can amyotrophic lateral sclerosis be relieved?

Amyotrophic lateral sclerosis (ALS) refers to a motor neuron disease, and generally speaking, there are no effective alleviation measures for this disease. Currently, the specific causes and pathogenesis of this disease are not very clear. Various factors lead to the simultaneous damage of both upper and lower motor neurons in patients. Clinical manifestations include muscle weakness, muscle atrophy, and fasciculations. Additionally, patients may experience difficulties with swallowing, choking while drinking water, and speech disorders. In its most severe form, it can affect breathing, leading to respiratory failure. This disease progressively worsens, and the prognosis is generally poor with no effective relief methods available.

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Written by Liu Hong Mei
Neurology
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What should people with ALS do if they cannot eat?

People with amyotrophic lateral sclerosis who are unable to eat may try liquid and semi-liquid diets, using warm liquids, eating little by little. If they cannot consume a liquid diet, they may need to resort to nasogastric feeding. A gastric tube is used for feeding, through which high-nutrition, high-protein, and high-calorie diets can be provided to sustain and extend the life of those with the condition. Avoid overeating and engage in appropriate exercise, paying attention to the functions of the respiratory and digestive systems. If there is excessive saliva, a small amount of antihistamine medication can be administered. If there is an excess of phlegm, nebulized inhalation and expectorant medications might be provided. If feeding through a gastric tube is also limited, intravenous nutritional support can be given.

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Written by Liu Hong Mei
Neurology
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Do people with early ALS have leg pain?

Early-stage ALS (Amyotrophic Lateral Sclerosis) patients often experience leg pain symptoms. ALS is generally caused by factors such as inflammatory reactions, genetic factors, neuronal apoptosis, infection, autoimmunity, and metal poisoning. These factors may lead to the degenerative death of nerve cells, causing muscle atrophy, muscle weakness, fasciculations, increased muscle tone, hyperactive tendon reflexes, and symptoms of muscle fatigue, muscle tension, and muscle pain. In the early stages of ALS, muscle fatigue can occur after activity due to lactic acid not being properly expelled, leading to muscle pain. Treatments such as acupuncture, physiotherapy, and massage can be administered to alleviate these symptoms.

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Written by Li Qiang
Intensive Care Unit
51sec home-news-image

What to do with respiratory failure in the late stage of amyotrophic lateral sclerosis?

Amyotrophic Lateral Sclerosis (ALS) is an irreversible disease, also known as motor neuron disease. Its motor function deteriorates progressively and irreversibly. Therefore, in the advanced stages, respiratory failure can only be managed with the help of a ventilator, which assists the patient's breathing mechanically. Consequently, patients typically require a tracheotomy in the late stages of the disease. Once connected to a ventilator via a tracheotomy, the ventilator becomes a permanent necessity. If at any point the ventilator is stopped, the patient would die due to lack of oxygen and the accumulation of carbon dioxide in the body. Therefore, they must wear the ventilator for life. Inevitably, this leads to respiratory-related complications, such as lung infections.