Is it necessary to perform a tracheotomy in the late stages of ALS?

Written by Li Qiang
Intensive Care Unit
Updated on September 23, 2024
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Patients in the late stages of amyotrophic lateral sclerosis (ALS) must undergo a tracheotomy because, by this stage, they have completely lost their motor abilities, including the muscle strength needed for breathing. Consequently, they lack the strength to breathe on their own, leaving them unable to survive without a ventilator. They must rely continuously on a ventilator to breathe as they cannot do it themselves. Therefore, if a ventilator is needed over the long term, a tracheotomy is necessary. This is because other methods, such as inserting tubes through the mouth or nose into the trachea to connect to the ventilator, are quite uncomfortable. Comparatively, tracheotomy offers a bit more comfort, making it a necessary procedure for connecting to a ventilator for long-term use and achieving greater comfort.

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Written by Zhang Hui
Neurology
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Can amyotrophic lateral sclerosis be relieved?

Amyotrophic lateral sclerosis (ALS) refers to a motor neuron disease, and generally speaking, there are no effective alleviation measures for this disease. Currently, the specific causes and pathogenesis of this disease are not very clear. Various factors lead to the simultaneous damage of both upper and lower motor neurons in patients. Clinical manifestations include muscle weakness, muscle atrophy, and fasciculations. Additionally, patients may experience difficulties with swallowing, choking while drinking water, and speech disorders. In its most severe form, it can affect breathing, leading to respiratory failure. This disease progressively worsens, and the prognosis is generally poor with no effective relief methods available.

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Written by Liu Hong Mei
Neurology
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How long does it take for someone with ALS to go from onset to paralysis?

Patients with amyotrophic lateral sclerosis generally progress from onset to paralysis within three to four years. The condition typically involves the progressive degeneration, degeneration, and necrosis of brain nerve cells. Severe and irreversible damage can occur in the brain, spinal cord, and peripheral nerves, also known as motor neuron disease. Motor neuron disease restricts our movement, speech, swallowing, breathing, and muscle activity, causing muscles to gradually atrophy and degenerate, leading to progressive weakness and paralysis. Even speaking, swallowing, and breathing functions degrade, potentially leading to respiratory failure and life-threatening situations, requiring proactive treatment.

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Written by Liu Hong Mei
Neurology
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What should people with ALS do if they cannot eat?

People with amyotrophic lateral sclerosis who are unable to eat may try liquid and semi-liquid diets, using warm liquids, eating little by little. If they cannot consume a liquid diet, they may need to resort to nasogastric feeding. A gastric tube is used for feeding, through which high-nutrition, high-protein, and high-calorie diets can be provided to sustain and extend the life of those with the condition. Avoid overeating and engage in appropriate exercise, paying attention to the functions of the respiratory and digestive systems. If there is excessive saliva, a small amount of antihistamine medication can be administered. If there is an excess of phlegm, nebulized inhalation and expectorant medications might be provided. If feeding through a gastric tube is also limited, intravenous nutritional support can be given.

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Written by Liu Hong Mei
Neurology
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Do people with ALS experience frequent muscle twitching?

Muscle twitching in people with ALS (Amyotrophic Lateral Sclerosis) can be very frequent. When muscles in ALS patients experience spasms, irritation, weakness, or fatigue, twitching is likely to occur. Muscle twitching in ALS patients is generally very frequent and is related to the disease. ALS, often referred to as motor neuron disease, is caused by degenerative changes in the central nervous system, such as the spinal cord and brain, leading to damage in the neuromuscular system, resulting in muscle atrophy, twitching, and tremors. It is advisable to seek medical evaluation and, once diagnosed, pursue active treatment which may include nutritional support, massage acupuncture, and functional exercise.

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Written by Li Qiang
Intensive Care Unit
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What to do with respiratory failure in the late stage of amyotrophic lateral sclerosis?

Amyotrophic Lateral Sclerosis (ALS) is an irreversible disease, also known as motor neuron disease. Its motor function deteriorates progressively and irreversibly. Therefore, in the advanced stages, respiratory failure can only be managed with the help of a ventilator, which assists the patient's breathing mechanically. Consequently, patients typically require a tracheotomy in the late stages of the disease. Once connected to a ventilator via a tracheotomy, the ventilator becomes a permanent necessity. If at any point the ventilator is stopped, the patient would die due to lack of oxygen and the accumulation of carbon dioxide in the body. Therefore, they must wear the ventilator for life. Inevitably, this leads to respiratory-related complications, such as lung infections.