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Research ArticleEditor's Choice

The Oral Secretion Scale and Prognostic Factors for Survival in Subjects With Amyotrophic Lateral Sclerosis

Pamela A Cazzolli, Benjamin Rix Brooks, Yuki Nakayama, Joseph S Lewarski, Douglas A McKim, Sheryl L Holt and Robert L Chatburn
Respiratory Care August 2020, 65 (8) 1063-1076; DOI: https://doi.org/10.4187/respcare.07005
Pamela A Cazzolli
ALS Care Project, Canton, Ohio.
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  • For correspondence: [email protected]
Benjamin Rix Brooks
Carolinas Neuromuscular/ALS-MDA Care Center, Atrium Health Neurosciences Institute, Department of Neurology, Carolinas Medical Center, University of North Carolina School of Medicine – Charlotte Campus, Charlotte, North Carolina.
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Yuki Nakayama
ALS Care Project, Canton, Ohio.
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Joseph S Lewarski
RC Medical, Wickliffe, Ohio.
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Douglas A McKim
University of Ottawa, CANVent Respiratory Rehabilitation Services, The Ottawa Rehabilitation Centre, and The Ottawa Hospital Sleep Centre, Ottawa, Canada, Ottawa Hospital Research Institute.
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Sheryl L Holt
Physical Therapy Department, University of Mount Union, Alliance, Ohio, ALS Care Project Canton, Ohio.
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Robert L Chatburn
Respiratory Institute, Cleveland Clinic Foundation, Department of Medicine, Lerner College of Medicine, Case Western Reserve University, Cleveland, Ohio.
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References

  1. 1.↵
    1. Braun SR
    . Respiratory system in amyotrophic lateral sclerosis. Neurol Clin 1987;5(1):9-31.
    OpenUrlPubMedWeb of Science
  2. 2.↵
    1. Sivak ED,
    2. Streib EW
    . Management of hypoventilation in motor neuron disease presenting with respiratory insufficiency. Ann Neurol 1980;7(2):188-191.
    OpenUrlCrossRefPubMedWeb of Science
  3. 3.↵
    1. Benditt JO,
    2. Boitano L
    . Respiratory treatment of amyotrophic lateral sclerosis. Phys Med Rehabil Clin N Am 2008;19(3):559-572.
    OpenUrlPubMedWeb of Science
  4. 4.
    1. McKim DA,
    2. Road J,
    3. Avendano M,
    4. Abdool S,
    5. Cote F,
    6. Duguid N,
    7. et al
    ; Canadian Thoracic Society Home Mechanical Ventilation Committee. Home mechanical ventilation: a Canadian Thoracic Society clinical practice guideline. Can Respir J 2011;18(4):197-215.
    OpenUrlPubMed
  5. 5.↵
    1. Hess DR
    . Noninvasive ventilation for neuromuscular disease. Clin Chest Med 2018;39(2):437-447.
    OpenUrl
  6. 6.↵
    1. Oppenheimer EA
    . Decision-making in the respiratory care of amyotrophic lateral sclerosis: should home mechanical ventilation be used? Palliat Med 1993;7(4 Suppl):49-64.
    OpenUrlPubMed
  7. 7.
    1. Bach JR
    . Amyotrophic lateral sclerosis: prolongation of life by noninvasive respiratory aids. Chest 2002;122(1):92-98.
    OpenUrlCrossRefPubMedWeb of Science
  8. 8.↵
    1. Cazzolli PA,
    2. Oppenheimer EA
    . Home mechanical ventilation for amyotrophic lateral sclerosis: nasal compared to tracheostomy-intermittent positive pressure ventilation. J Neurol Sci 1996;139(Suppl):123-128.
    OpenUrlCrossRefPubMedWeb of Science
  9. 9.↵
    1. Vandenberghe N,
    2. Vallet AE,
    3. Petitjean T,
    4. Le Cam P,
    5. Peysson S,
    6. Guérin C,
    7. et al
    . Absence of airway secretion accumulation predicts tolerance of noninvasive ventilation in subjects with amyotrophic lateral sclerosis. Respir Care 2013;58(9):1424-1432.
    OpenUrlAbstract/FREE Full Text
  10. 10.↵
    1. Aboussouan LS,
    2. Khan SU,
    3. Meeker DP,
    4. Stelmach K,
    5. Mitsumoto H
    . Effect of noninvasive positive-pressure ventilation on survival in amyotrophic lateral sclerosis. Ann Intern Med 1997;127(6):450-453.
    OpenUrlCrossRefPubMedWeb of Science
  11. 11.
    1. Aboussouan LS,
    2. Khan SU,
    3. Banerjee M,
    4. Arroliga AC,
    5. Mitsumoto H
    . Objective measures of the efficacy of noninvasive positive-pressure ventilation in amyotrophic lateral sclerosis. Muscle Nerve 2001;24(3):403-409.
    OpenUrlCrossRefPubMed
  12. 12.
    1. Gruis KL,
    2. Brown DL,
    3. Schoennemann A,
    4. Zebarah VA,
    5. Feldman EL
    . Predictors of noninvasive ventilation tolerance in patients with amyotrophic lateral sclerosis. Muscle Nerve 2005;32(6):808-811.
    OpenUrlCrossRefPubMed
  13. 13.
    1. Farrero E,
    2. Prats E,
    3. Povedano M,
    4. Martinez-Matos JA,
    5. Manresa F,
    6. Escarrabill J
    . Survival in amyotrophic lateral sclerosis with home mechanical ventilation: the impact of systematic respiratory assessment and bulbar involvement. Chest 2005;127(6):2132-2138.
    OpenUrlCrossRefPubMedWeb of Science
  14. 14.
    1. Bourke SC,
    2. Tomlinson M,
    3. Williams TL,
    4. Bullock RE,
    5. Shaw PJ,
    6. Gibson GJ
    . Effects of non-invasive ventilation on survival and quality of life in patients with amyotrophic lateral sclerosis: a randomized controlled trial. Lancet Neurol 2006;5(2):140-147.
    OpenUrlCrossRefPubMedWeb of Science
  15. 15.↵
    1. Lo Coco D,
    2. Marchese S,
    3. Pesco MC,
    4. La Bella V,
    5. Piccoli F,
    6. Lo Coco A
    . Noninvasive positive-pressure ventilation in ALS: predictors of tolerance and survival. Neurology 2006;67(5):761-765.
    OpenUrlCrossRefPubMed
  16. 16.↵
    1. Afkari S
    . Measuring frequency of spontaneous swallowing. Australas Phys Eng Sci Med 2007;30(4):313-317.
    OpenUrlPubMed
  17. 17.↵
    1. Rudney JD,
    2. Ji Z,
    3. Larson CJ
    . The prediction of saliva swallowing frequency in humans from estimates of salivary flow rate and the volume of saliva swallowed. Arch Oral Biol 1995;40(6):507-512.
    OpenUrlCrossRefPubMed
  18. 18.↵
    1. Lagerlof F,
    2. Dawes C
    . The volume of saliva in the mouth before and after swallowing. J Dent Res 1984;63(5):618-621.
    OpenUrlCrossRefPubMedWeb of Science
  19. 19.↵
    1. Mitsumoto H
    1. Mitsumoto H
    . The clinical features and prognosis of amyotrophic lateral sclerosis. In: Mitsumoto H, editor. Amyotrophic lateral sclerosis: a guide for patients and families. 3rd edition. New York: Demos; 2009:21-42.
  20. 20.↵
    1. Hillel AD,
    2. Miller R
    . Bulbar amyotrophic lateral sclerosis: patterns of progression and clinical management. Head Neck 1989;11(1):51-59.
    OpenUrlCrossRefPubMedWeb of Science
  21. 21.↵
    1. Abdelnour-Mallet M,
    2. Tezenas Du Montcel S,
    3. Cazzolli PA,
    4. Assouline A,
    5. Pointon C,
    6. Leveque N,
    7. et al
    . Validation of robust tools to measure sialorrhea in amyotrophic lateral sclerosis: a study in a large French cohort. Amyotroph Lateral Scler Frontotemporal Degener 2013;14(4):302-307.
    OpenUrl
  22. 22.↵
    1. Nakayama Y,
    2. Ogura A,
    3. Matsuda C,
    4. Shimizu T,
    5. Cazzolli PA,
    6. Brooks BR
    . Oral secretion scale – test-re-test reliability pilot study in a Japanese amyotrophic lateral sclerosis population [Abstract]. Amyotroph Lateral Scler 2010;11(Suppl):141.
    OpenUrl
  23. 23.↵
    1. Brooks BR
    . El Escorial World Federation of Neurology criteria for the diagnosis of amyotrophic lateral sclerosis. Subcommittee on Motor Neuron Diseases/Amyotrophic Lateral Sclerosis of the World Federation of Neurology Research Group on Neuromuscular Diseases and the El Escorial “Clinical limits of amyotrophic lateral sclerosis” workshop contributors. J Neurol Sci 1994;124(Suppl):96-107.
    OpenUrlCrossRefPubMedWeb of Science
  24. 24.↵
    1. Herdman TH,
    2. Kamitsuru S
    , editors. NANDA international nursing diagnoses: definitions and classification. 11th edition. New York: Thieme; 2018.
  25. 25.↵
    1. Newall AR,
    2. Orser R,
    3. Hunt M
    . The control of oral secretions in bulbar ALS/MND. J Neurol Sci 1996;139 (Suppl):43-44.
    OpenUrlCrossRefPubMed
  26. 26.↵
    1. Cedarbaum JM,
    2. Stambler N,
    3. Malta E,
    4. Fuller C,
    5. Hilt D,
    6. Thurmond B,
    7. Nakanishi A
    . The ALSFRS-R: a revised ALS functional rating scale that incorporates assessment of respiratory function. J Neurol Sci 1999;169(1-2):13-21.
    OpenUrlCrossRefPubMedWeb of Science
  27. 27.↵
    1. Hill NS
    1. Hill NH,
    2. Hess D
    . Initiation of noninvasive positive pressure ventilation. In: Hill NS, editor. Noninvasive positive pressure ventilation: principles and applications. New York: Futura; 2001:27-40.
  28. 28.↵
    1. Radunovic A,
    2. Annane D,
    3. Rafiq MK,
    4. Mustfa N
    . Mechanical ventilation for amyotrophic lateral sclerosis/motor neuron disease. Cochrane Database Syst Rev 2013;(3):CD004427.
    OpenUrlPubMed
  29. 29.↵
    1. Sancho J,
    2. Servera E,
    3. Morelot-Panzini C,
    4. Salachas F,
    5. Similowski T,
    6. Gonzalez-Bermejo J
    . Non-invasive ventilation effectiveness and the effect of ventilator mode on survival in ALS patients. Amyotroph Lateral Scler Frontotemporal Degener 2014;15(1-2):55-61.
    OpenUrl
  30. 30.↵
    1. Gonzalez Calzada N,
    2. Prats Soro E,
    3. Mateu Gomez L,
    4. Giro Bulta E,
    5. Cordoba Izquierdo A,
    6. Povedano Panades M,
    7. et al
    . Factors predicting survival in amyotrophic lateral sclerosis patients on non-invasive ventilation. Amyotroph Lateral Scler and Frontotemporal Degener 2016;17(5-6):337-342.
    OpenUrl
  31. 31.↵
    1. Berlowitz DJ,
    2. Howard ME,
    3. Fiore JF,
    4. Vander Hoorn S,
    5. O'Donoghue FJ,
    6. Westlake J,
    7. et al
    . Identifying who will benefit from non-invasive ventilation in amyotrophic lateral sclerosis/motor neurone disease in a clinical cohort. J Neurol Neurosurg Psychiatry 2016;87(3):280-286.
    OpenUrlAbstract/FREE Full Text
  32. 32.↵
    1. Sancho J,
    2. Servera E,
    3. Chiner E,
    4. Bañuls P,
    5. Gómez-Merino E,
    6. Sancho-Chust JN,
    7. Marín J
    . Noninvasive respiratory muscle aids during PEG placement in ALS patients with severe ventilator impairment. J Neurol Sci 2010;297(1-2):55-59.
    OpenUrlCrossRefPubMed
  33. 33.↵
    1. Czell D,
    2. Bauer M,
    3. Binek J,
    4. Schoch OD,
    5. Weber M
    . Outcomes of percutaneous endoscopic gastrostomy tube insertion in respiratory impaired amyotrophic lateral sclerosis patients under noninvasive ventilation. Respir Care 2013;58(5):838-844.
    OpenUrlAbstract/FREE Full Text
  34. 34.↵
    Centers for Medicare & Medicaid Services. Respiratory Assist Device-EO471; Restrictive Thoracic Disorder: Revised April 24, 2019. https://www.cgsmedicare.com/pdf/dme_checklists/rad_e0471_2018re.pdf.
  35. 35.↵
    1. Andersen PM,
    2. Abrahams S,
    3. Borasio GD,
    4. de Carvalho M,
    5. Chio A,
    6. et al
    EFNS Task Force on Diagnosis and Management of Amyotrophic Lateral Sclerosis, Andersen PM, Abrahams S, Borasio GD, de Carvalho M, Chio A, et al. EFNS guidelines on the clinical management of amyotrophic lateral sclerosis (MALS) – revised report of an EFNS task force. Eur J Neurol 2012;19(3):360-375.
    OpenUrlCrossRefPubMed
  36. 36.↵
    National Institute for Health and Care Excellence. (NICE Guideline [NG 42]). Motor neurone disease: assessment and management: non-invasive ventilation. National Clinical Guideline Centre, February 2016: 276-294. www.nice.org.UK
  37. 37.↵
    1. Gruis KL,
    2. Lechtzin N
    . Respiratory therapies for amyotrophic lateral sclerosis: a primer. Muscle Nerve 2012; 46(3):313-331.
    OpenUrlCrossRefPubMed
  38. 38.↵
    1. Benditt JO
    . Respiratory care of patients with neuromuscular disease. Respir Care 2019;64(6):679-688.
    OpenUrlAbstract/FREE Full Text
  39. 39.↵
    1. Oppenheimer EA
    . Treating respiratory failure in ALS: the details are becoming clearer. J Neurol Sci 2003;209(1-2):1-4.
    OpenUrlCrossRefPubMedWeb of Science
  40. 40.↵
    1. Andersen T,
    2. Sandnes A,
    3. Brekka AK,
    4. Hilland M,
    5. Clemm H,
    6. Fondenes O,
    7. et al
    . Laryngeal response patterns influence the efficacy of mechanical assisted cough in amyotrophic lateral sclerosis. Thorax 2017;72(3):221-229.
    OpenUrlAbstract/FREE Full Text
  41. 41.↵
    1. Sancho J,
    2. Servera E,
    3. Diaz J,
    4. Marin J
    . Efficacy of mechanical insufflation-exsufflation in medically stable patients with amyotrophic lateral sclerosis. Chest 2004;125(4):1400-1405.
    OpenUrlCrossRefPubMedWeb of Science
  42. 42.↵
    1. Oppenheimer EA,
    2. Fischer JR
    . Oxygen is not appropriate therapy for hypoventilation in neuromuscular disease. ADVANCE for Managers of Respir Care 2001;10(2):44-45.
    OpenUrl
  43. 43.
    1. Gay PC,
    2. Edmonds LG
    . Severe hypercapnia after low-flow oxygen therapy in patients with neuromuscular disease and diaphragmatic dysfunction. Mayo Clin Proc 1995;70(4):327-330.
    OpenUrlCrossRefPubMedWeb of Science
  44. 44.
    1. Bach JR,
    2. Alba AS
    . Management of chronic alveolar hypoventilation by nasal ventilation. Chest 1990;97(1):52-57.
    OpenUrlCrossRefPubMedWeb of Science
  45. 45.↵
    1. Polkey MI,
    2. Lyall RA,
    3. Davidson AC,
    4. Leigh PN,
    5. Moxham J
    . Ethical and clinical issues in the use of home non-invasive mechanical ventilation for the palliation of breathlessness in motor neurone disease. Thorax 1999;54(4):367-371.
    OpenUrlFREE Full Text
  46. 46.↵
    1. De Vito EL,
    2. Suárez AA,
    3. Monteiro SG
    . The use of full-setting non-invasive ventilation in the home care of people with amyotrophic lateral sclerosis-motor neuron disease with end-stage respiratory muscle failure: a case series. J Med Case Rep 2012;6:42.
    OpenUrl
  47. 47.↵
    1. Cazzolli PA,
    2. Nakayama Y,
    3. Brooks BR,
    4. Lewarski JS,
    5. McKim DA,
    6. Chatburn RL
    . Survival and outcomes of 122 patients with ALS/MND using tracheostomy ventilation (TV). Amyotroph Lateral Scler and Frontotemporal Degener 2018;19(Suppl S1):83.
    OpenUrl
  48. 48.↵
    1. Moss AH,
    2. Oppenheimer EA,
    3. Casey P,
    4. Cazzolli PA,
    5. Roos RP,
    6. Stocking CB,
    7. Siegler M
    . Patients with amyotrophic lateral sclerosis receiving long-term mechanical ventilation: advance care planning and outcomes. Chest 1996;110(1):249-255.
    OpenUrlCrossRefPubMedWeb of Science
  49. 49.
    1. Nakayama Y,
    2. Shimizu T,
    3. Mochizuki Y,
    4. Hayashi K,
    5. Matsuda C,
    6. Nagao M,
    7. et al
    . Predictors of impaired communication in amyotrophic lateral sclerosis patients with tracheostomy-invasive ventilation. Amyotroph Lateral Scler Frontotemporal Degener 2015;17(1-2):38-46.
    OpenUrl
  50. 50.
    1. Bach JR
    . Amyotrophic lateral sclerosis. Communication status and survival with ventilatory support. Am J Phys Med Rehabil 1993;72(6):343-349.
    OpenUrlPubMedWeb of Science
  51. 51.↵
    1. Ambrosino N,
    2. Goldstein RS
    1. Cazzolli PA
    . The perspective of family and caregivers. In: Ambrosino N, Goldstein RS, editors. Ventilatory support for chronic respiratory failure. Lung Biology in Health and Diseases. New York: Informa; 2008. 225:489-500.
    OpenUrl
  52. 52.↵
    Clinical indications for noninvasive positive pressure ventilation in chronic respiratory failure due to restrictive lung disease, COPD, and nocturnal hypoventilation-a consensus conference report. Chest 1999;116(2):521-534.
    OpenUrlCrossRefPubMedWeb of Science
  53. 53.
    1. Miller RG,
    2. Rosenberg JA,
    3. Gelinas DF,
    4. Mitsumoto H,
    5. Newman D,
    6. Sufit R,
    7. et al
    . Practice parameter: the care of the patient with amyotrophic lateral sclerosis (an evidence-based review): report of the Quality Standards Subcommittee of the American Academy of Neurology: ALS Practice Parameters Task Force. Neurology 1999;52(7):1311-1323.
    OpenUrlCrossRefPubMed
  54. 54.↵
    1. Miller RG,
    2. Jackson CE,
    3. Kasarskis EJ,
    4. England JD,
    5. Forshew D,
    6. Johnston W,
    7. et al
    ; Quality Standards Subcommittee of the American Academy of Neurology. Practice parameter update: the care of the patient with amyotrophic lateral sclerosis: drug, nutritional, and respiratory therapies (an evidence-based review): report of the Quality Standards Subcommittee of the American Academy of Neurology. Neurology 2009;73(15):1218-1226.
    OpenUrlCrossRefPubMed
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The Oral Secretion Scale and Prognostic Factors for Survival in Subjects With Amyotrophic Lateral Sclerosis
Pamela A Cazzolli, Benjamin Rix Brooks, Yuki Nakayama, Joseph S Lewarski, Douglas A McKim, Sheryl L Holt, Robert L Chatburn
Respiratory Care Aug 2020, 65 (8) 1063-1076; DOI: 10.4187/respcare.07005

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The Oral Secretion Scale and Prognostic Factors for Survival in Subjects With Amyotrophic Lateral Sclerosis
Pamela A Cazzolli, Benjamin Rix Brooks, Yuki Nakayama, Joseph S Lewarski, Douglas A McKim, Sheryl L Holt, Robert L Chatburn
Respiratory Care Aug 2020, 65 (8) 1063-1076; DOI: 10.4187/respcare.07005
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Keywords

  • amyotrophic lateral sclerosis
  • end-of-life care
  • hospice
  • mechanical insufflation-exsufflation
  • noninvasive ventilation
  • oral secretions
  • oropharyngeal suctioning
  • survival
  • tracheostomy and invasive ventilation
  • upper-airway clearance

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