What is the role of oxygen administration in the treatment of amyotrophic lateral sclerosis (ALS)?

Updated: Jan 02, 2020
  • Author: Divakara Kedlaya, MBBS; Chief Editor: Ryan O Stephenson, DO  more...
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Answer

Answer

Oxygen administration depresses the respiratory drive as in chronic obstructive pulmonary disease (COPD). The underlying reason for the patient's hypoxemia is not lack of perfusion but rather lack of adequate ventilation. Oxygen administration can lead to worsening hypercapnia; therefore, hypoxia in these patients initially should be treated by increasing ventilation, either noninvasively or invasively.

Reserve oxygen administration for patients whose hypoxemia is not reversed with ventilatory support. In such patients, usually an underlying process, such as pneumonia, has resulted in decreased pulmonary perfusion. This situation necessitates oxygen administration, but oxygen should be given only once the airway has been secured and the patient is invasively ventilated. Invasive ventilation in this instance should be temporary until the secondary process has been treated. Following adequate treatment, the patient should be able to return to his or her previous respiratory management.


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