HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Figures Only Full Text Full Text (PDF) Correspondence: Submit a response Alert me when this article is cited Alert me when Correspondence are posted Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Hayashi, H. Articles by Oppenheimer, E. A. Search for Related Content PubMed PubMed Citation Articles by Hayashi, H. Articles by Oppenheimer, E. A. Related Collections Amyotrophic lateral sclerosis Natural history studies (prognosis)

ALS patients on TPPV

Totally locked-in state, neurologic findings and ethical implications

From the Department of Neurology (Dr. Hayashi), Tokyo Metropolitan Neurological Hospital, Japan; and Pulmonary Medicine (Dr. Oppenheimer), University of California School of Medicine, Los Angeles.

Address correspondence and reprint requests to Dr. H. Hayashi, Department of Neurology, Tokyo Metropolitan Neurological Hospital, 2-6-1 Musashidai, Fuchu, Tokyo, 183-0042, Japan.

Seventy patients with ALS using tracheostomy positive pressure ventilation (TPPV) were evaluated for impaired communication. Severely impaired communication is divided into the totally locked-in state (TLS) and the minimal communication state (MCS). TLS occurred in 8 of 70 (11.4%). In the 33 patients on TPPV for more than 5 years, TLS developed in 6 (18.2%) and MCS in 11 (33.1%). Respiratory management for ALS allows long-term survival if mechanical ventilation is used.

This article has been cited by other articles:

				H. Mitsumoto and J. G. Rabkin Palliative Care for Patients With Amyotrophic Lateral Sclerosis: "Prepare for the Worst and Hope for the Best" JAMA, July 11, 2007; 298(2): 207 - 216. [Abstract] [Full Text] [PDF]

				D. Lo Coco, S. Marchese, V. La Bella, T. Piccoli, and A. Lo Coco The Amyotrophic Lateral Sclerosis Functional Rating Scale Predicts Survival Time in Amyotrophic Lateral Sclerosis Patients on Invasive Mechanical Ventilation Chest, July 1, 2007; 132(1): 64 - 69. [Abstract] [Full Text] [PDF]