Rinsho Shinkeigaku (Clinical Neurology)

Original Article

Percutaneous endoscopic gastrostomy in amyotrophic lateral sclerosis -Relation of respiratory function at the time of PEG to survival length-

Toshio Shimizu, M.D.1)2), Hideaki Hayashi, M.D.1)2), Hitoshi Inoue, M.D.3), Kazuhiro Imamura, M.D.3) and Kiyomitsu Oyanagi, M.D., Ph.D.4)5)

1)Nutrition Support Team, Tokyo Metropolitan Neurological Hospital
2)Department of Neurology, Tokyo Metropolitan Neurological Hospital
3)Department of Surgery, Tokyo Metropolitan Fuchu Hospital
4)Department of Neuropathology, Tokyo Metropolitan Institute for Neuroscience
5)Department of Pathology, Tokyo Metropolitan Neurological Hospital

We investigated retrospectively 35 patients with amyotrophic lateral sclerosis who underwent percutaneous endoscopic gastrostomy (PEG), focusing on their respiratory function at the time of PEG. There were statistically significant correlations between the forced vital capacity and arterial carbon dioxide pressure, and the duration from the PEG to death or initiation of ventilatory support. In comparison between the 20 patients who died or was placed on ventilator within 6 months after PEG (group A) and the 15 patients who survived more than 6 months without ventilatory support after PEG (group B), the arterial carbon dioxide pressure showed a significantly high level in the group A (mean 47.5±S.D. 5.4 mmHg) than in the group B (42.2±5.2 mmHg) (P < 0.05). PEG should be performed in ALS patients while respiratory function is well preserved, especially before arterial carbon dioxide pressure is increased.
Full Text of this Article in Japanese PDF (455K)

(CLINICA NEUROL, 48: 721|726, 2008)
key words: percutaneous endoscopic gastrostomy, amyotrophic lateral sclerosis, respiratory function, survival, nutritional support

(Received: 9-Jun-08)