NIV for ventilatory support during percutaneous endoscopic gastrostomy (PEG) in ALS patients with respiratory failure

Aim: The aim of the study is to evaluate safety and usefulness of PEG placement in ALS patients with respiratory failure supported with NIV during this procedure. Material and methods: We analyzed the group of 17 ALS with respiratory failure admitted for PEG placement and starting NIV on period of two years (2007-2009). Mean period from the establishing diagnose was 2, 2±1, 2 years. Mean survival on home mechanical ventilation was 7, 1±4, 4 months. They were first accommodated to NIV with full face mask. Mean age was 55, 3±11, 06 (10 males and 7 females). Mean hospital staying was 8, 3±4, 52 days. Mean PaO2 was 9, 29±0,43kPa, PaCO2 7, 19±0,54kPa. Mean FVC was 38, 37±15, 01%. Bulbar symptoms had 48% of patients. NIV was used for ventilatory support during PEG. The team included very skilled surgeon for PEG placement and pulmonary physician for NIV. One patient had classical surgical gastrostomy and feeding tube placement on NIV. No respiratory complications occurred in any of these patients to be at high risk for PEG placement. Conclusions: Placement of PEG in patients with respiratory failure and high risk for this procedure is safe if the team is skilled for PEG placement and NIV.