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Review ArticleSystematic Review

Use of Noninvasive Ventilation During Feeding Tube Placement

Paolo Banfi, Eleonora Volpato, Chiara Valota, Salvatore D'Ascenzo, Chiara Bani Alunno, Agata Lax, Antonello Nicolini, Nicola Ticozzi, Vincenzo Silani and John R Bach
Respiratory Care November 2017, 62 (11) 1474-1484; DOI: https://doi.org/10.4187/respcare.05031
Paolo Banfi
IRCCS Fondazione Don Carlo Gnocchi, Milan, Italy.
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  • For correspondence: pabanfi@dongnocchi.it
Eleonora Volpato
IRCCS Fondazione Don Carlo Gnocchi, Milan, Italy.Department of Psychology, Università Cattolica del Sacro Cuore, Milan, Italy.
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Chiara Valota
Department of Psychology, Università Cattolica del Sacro Cuore, Milan, Italy.
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Salvatore D'Ascenzo
IRCCS Fondazione Don Carlo Gnocchi, Milan, Italy.
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Chiara Bani Alunno
IRCCS Fondazione Don Carlo Gnocchi, Milan, Italy.
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Agata Lax
IRCCS Fondazione Don Carlo Gnocchi, Milan, Italy.
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Antonello Nicolini
Respiratory Rehabilitation Unit, ASL 4 Chiavarese, Hospital of Sestri Levante, Italy.
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Nicola Ticozzi
Unit of Neurology and Laboratory of Neuroscience, Istituto Auxologico Italiano, Istituto di Ricovero e Cura a Carattere Scientifico and the Department of Pathophysiology and Transplantation, Dino Ferrari Center, Università degli Studi di Milano, Milan, Italy.
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Vincenzo Silani
Unit of Neurology and Laboratory of Neuroscience, Istituto Auxologico Italiano, Istituto di Ricovero e Cura a Carattere Scientifico and the Department of Pathophysiology and Transplantation, Dino Ferrari Center, Università degli Studi di Milano, Milan, Italy.
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John R Bach
Department of Physical Medicine and Rehabilitation, Rutgers University–New Jersey Medical School, Newark, New Jersey.
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Abstract

Parenteral nutrition is indicated in amyotrophic lateral sclerosis (ALS) when dysphagia, loss of appetite, and difficulty protecting the airways cause malnutrition, severe weight loss, dehydration, and increased risk of aspiration pneumonia. The aim of this review is to compare percutaneous endoscopic gastrostomy (PEG), radiologically inserted G-tube (RIG), and percutaneous radiologic gastrostomy (PRG) in patients with ALS, performed with or without noninvasive ventilation (NIV). We searched PubMed, MEDLINE, EMBASE, the Cochrane Central Register of Controlled Trials (CENTRAL), the EBSCO Online Research Database, and Scopus up to December 2015. A priori selection included all randomized controlled trials (RCTs), quasi-randomized trials, and prospective and retrospective studies. The primary outcome was 30-d survival. We found no RCTs or quasi-RCTs. Seven studies about the implementation of the PEG/RIG procedure during the use of NIV and 5 studies without NIV were included. In another study of 59 subjects undergoing open gastrostomy, all with vital capacity < 30% of normal, 18 of whom were dependent on continuous NIV at full ventilatory support settings, there were no respiratory complications. Thus, the use of NIV during the implementation of these procedures, especially when used at full ventilatory support settings of pressure preset 18–25 cm H2O, can support alveolar ventilation before, during, and after the procedures and prevent respiratory complications. The procedures investigated appear equivalent, but the methodological quality of the studies could be improved. Possible benefits with regard to nutrition parameters, quality of life, and psychological features need to be further investigated.

  • amyotrophic lateral sclerosis (ALS)
  • noninvasive ventilation (NIV)
  • gastrostomy
  • clinical effectiveness
  • quality of life (QOL)
  • systematic review

Footnotes

  • Correspondence: Banfi Paolo MD, Fondazione Don Carlo Gnocchi, HD Respiratory Rehabilitation Unit, Via Capecelatro, 66-CAP, 20149 Milan, Italy. E-mail: pabanfi{at}dongnocchi.it.
  • Supplementary material related to this paper is available at http://www.rcjournal.com.

  • The authors have disclosed no conflicts of interest.

  • Copyright © 2017 by Daedalus Enterprises
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Respiratory Care: 62 (11)
Respiratory Care
Vol. 62, Issue 11
1 Nov 2017
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Use of Noninvasive Ventilation During Feeding Tube Placement
Paolo Banfi, Eleonora Volpato, Chiara Valota, Salvatore D'Ascenzo, Chiara Bani Alunno, Agata Lax, Antonello Nicolini, Nicola Ticozzi, Vincenzo Silani, John R Bach
Respiratory Care Nov 2017, 62 (11) 1474-1484; DOI: 10.4187/respcare.05031

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Use of Noninvasive Ventilation During Feeding Tube Placement
Paolo Banfi, Eleonora Volpato, Chiara Valota, Salvatore D'Ascenzo, Chiara Bani Alunno, Agata Lax, Antonello Nicolini, Nicola Ticozzi, Vincenzo Silani, John R Bach
Respiratory Care Nov 2017, 62 (11) 1474-1484; DOI: 10.4187/respcare.05031
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Keywords

  • amyotrophic lateral sclerosis (ALS)
  • noninvasive ventilation (NIV)
  • gastrostomy
  • clinical effectiveness
  • quality of life (QOL)
  • systematic review

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