Lung Volume Recruitment Slows Pulmonary Functional Decline and Prolongs Survival in ALS.

BACKGROUND AND PURPOSE: Few studies have examined the long-term effects of lung volume recruitment (LVR) in amyotrophic lateral sclerosis (ALS). This study aimed to clarify the impact of LVR on respiratory function (Aim 1) and survival (Aim 2).

METHODS

This retrospective cohort included hospitalized patients with ALS who underwent LVR from 2015 to 2020. For Aim 1, longitudinal changes in forced vital capacity (%FVC) were assessed every 3 months before and after LVR. For Aim 2, the survival study, data on sex, onset age, delay in diagnosis, duration of LVR, and subtype were also collected.

RESULTS

A total of 79 patients underwent LVR (Aim 2), 48 patients had %FVC data before and after LVR (Aim 1). Regarding long-term effects on respiratory function (Aim 1), %FVC declined at approximately 2% per month before LVR, with significant decreases observed at 12, 9, and 6 months relative to baseline ( P < .001). After LVR, the decline slowed to less than 1% per month, and no significant decreases were observed at 3, 6, 9, or 12 months. In Aim 2, patients continuing LVR ≥6 months had longer survival than those with shorter use. Multivariate Cox regression identified LVR ≥6 months as a prognostic factor (hazard ratio [95% CI] = 0.42 [0.19-0.96], P = .04).

DISCUSSION AND

CONCLUSIONS

These findings suggest a potential association between continued LVR and both a slower decline in %FVC and longer survival in patients with ALS. Further prospective studies are warranted to confirm these findings.

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