Abstract Details

Title The role of arterial blood gas analysis (ABG) in Amyotrophic Lateral Sclerosis respiratory monitoring

Topic Neuromuscular and Clinical Neurophysiology (EMG)

Presentation(s) Neuromuscular and Clinical Neurophysiology (EMG) Posters (7:00 AM-5:00 PM)

Poster/Presentation
Number 046

Objective To determine correspondence between main arterial blood gases (ABG) parameters (carbon
dioxide, pCO2, blood carbonate, HCO3-, and standard base excess, SBE) and forced vital capacity
(FVC%), and their ability to predict non-invasive mechanical ventilation (NIMV) usage and survival in
ALS patients.

Background In both clinical practice and randomized clinical trials (RCTs), FVC and slow vital capacity (SVC) have
shown to be independent predictors of survival: they are used interchangeably, usually as primary
endpoint. It has not been clar if ABG should paly a role as a clinical marker of progression.

Design/Methods We collected ABGs and pulmonary function tests (PFTs) performed on ALS patients from the
Turin ALS Centre, diagnosed from 2000 to 2015. Clinical data were collected using registry data. pCO2,
HCO3-, and SBE were compared with FVC% and clinical data, both singularly and combined, to stratify
patients on the basis of significant cut-offs. Their ability to predict NIMV start at 3 months and overall
survival was assessed, adjusting for age, sex, clinical phenotypes, and progression rate.

Results 488 patients with paired ABGs, PFTs, and ALSFRS-r score were collected. Single ABG
parameters showed a significant correlation with FVC% values. A significant decline in FVC% values
was recorded for a pCO2 cut-off of 42 mmHg, for every HCO3- cut-off above 26 mmol/L, and every SBE
cut-off above 2 mmol/L. Each of the above mentioned ABGs cut-offs turned out to be the most sensitive
in predicting NIMV start at 3 months. ABGs measurements were predictive of death/tracheostomy only in patients who did not undergo NIMV.

Conclusions ABG is a sensitive substitute for other PFTs in ALS patients that should be used both in
clinical and experimental settings, especially considering HCO3-, SBE and pCO2 as early predictor of
respiratory failure.

Authors/Disclosures
Andrea Calvo, MD, PhD, F�鶹��ýӳ�� (Dept. of Neuroscience, University of Turin) PRESENTER	Dr. Calvo has nothing to disclose.
Umberto Manera, MD (Department of Neuroscience "Rita Levi Montalcini" - University of Torino)	Dr. Manera has nothing to disclose.
	No disclosure on file
Cristina Moglia (University of Torino)	Cristina Moglia has nothing to disclose.
Francesca Palumbo	No disclosure on file
Rosario Vasta, MD (University of Turin, Department of Neurosciences)	Dr. Vasta has nothing to disclose.
	No disclosure on file
	No disclosure on file
Gabriele Mora, MD	Dr. Mora has nothing to disclose.
Adriano Chio, MD, F�鶹��ýӳ�� (Dept. of Neuroscience, University of Turin)	Dr. Chio has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Cytokinetics. Dr. Chio has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Mitsubishi. Dr. Chio has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Biogen. Dr. Chio has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Corcept.

�鶹��ýӳ��

�鶹��ýӳ��