The Amyotrophic Lateral Sclerosis (ALS) is a degenerative illness, characterized by a progressive loss of motoneurons from cerebral cortex,brainstem and spinal cord.
The disease,with increased frequency,affects the population over 50 's, and in Italy is shown that every day 3 new cases of ALS arise while 6 ill patients are counted every 100.000 abitants.
Many are the effects that this disease produces,in particular we recall the irreversible and progressive loss of:swallowing normal capacity(dysphagia),words articulation(dysarthria),and skeletal muscles control whose paralysis(even if partial) in the end causes respiratory muscles compromission,condition that necessitates artificial ventilation.
The thesis aim is to emphasize the importance of non invasive Mechanical Ventilation(NIV) in respiratory insufficiency treatment.
A randomized controlled trial,focused on survival and increasing quality of life in ALS patients,demonstrates that non invasive ventilation gets better response in all subjects survival time in the subsample with higher conserved brainstem's funtion,while incease survivance with a significative manteniment of life quality in the sample of patients with minor brainstem's disfunction.
Even if NIV is a well tolerated treatment,the complications onset of this technique can lead the patient to a non-adherence behaving to the therapeutic approach itself,so the nurse must,with proficiency and competence,anticipate and manage in advance NIV secondary effects in order customer's compliance.
The patient must be cured in his globality,so it is essential for the sake of the person to have a qualified assistence provided by a multidiscipinary team able to assure phisical,psychological,and human support in all phases of the disease.
