The goal of this pilot observational study is to learn about the dynamic impact of the non invasive ventilation on the diaphragm in patient with amyotrophic lateral sclerosis. The main question it aims to answer : can diaphragmatic ultrasound detect differences in diaphragmatic motion (diaphragmactic excursion and diaphragmatic thickening between spontaneous breathing and non-invasive ventilation ? Participants will receive diaphragmatic ultrasound assessments both under spontaneous breathing and during non-invasive ventilation on their day hospital evaluation for ventilatory support.
Each diaphragmatic ultrasound assessment will be performed on both the right and left hemidiaphragms, with the patient in a semi-recumbent position at 30°, during a maximal inspiratory effort. The following parameters will be measured: * Diaphragmatic excursion using M-mode ultrasound with a low-frequency convex (abdominal) probe via a subcostal approach * Diaphragmatic thickening using B-mode ultrasound with a high-frequency linear (vascular) probe via the lateral axillary line Measurements will be obtained during spontaneous breathing and after 10 to 20 minutes of non-invasive ventilation (NIV), using ventilator settings deemed optimally adjusted by the supervising physician.
Study Type
OBSERVATIONAL
Enrollment
20
CHU Grenoble-Alpes
Grenoble, Isère, France
Composite : - Diaphragmatic excursion variation (DE) - Diaphragmatic thickening variation (DT)
Both DE and DT will be measured under spontaneous bretahing and under NIV. The outcomes will be compared, and the percentage variation between the two conditions will be recorded
Time frame: Day 1
Changes in transcutaneous carbon dioxide (TcCO₂) levels
The variation in TcCO₂ will be measured and compared with the variations in DE and DT to determine whether there is a correlation.
Time frame: Day 1
NIV Tolerance
NIV tolerance will be assessed using a numerical subjective scale from 0 to 10. The tolerance numercial scale will then be compared with variations in DE and DT to determine whether there is a correlation.
Time frame: Day 1
Pathophysiological type of ALS
For each patient, the bulbar type or the spinal type of ALS will be recorded. Subgroups analyses between spinal ALS and bulbar ALS. Some differences are to be expected.
Time frame: Day 1
Adherence of NIV
If a NIV is already instaured, the average adherence in hours per 24 hours will be recorded \- Subgroupes analyses between \< 8 hours/24h NIV adherence, and 8 hours/24h or more NIV adherence
Time frame: Day 1
This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.