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More people with ALS can get better breathing help – Gefle Dagblad

More people with ALS can get better breathing help – Gefle Dagblad

People with amyotrophic lateral sclerosis need help breathing. But few have access to the most effective method. Andreas Palm, MD, Gavle, wants to change that and has started a research study to shed light on the problem.

– He says that need, not place of residence, determines the type of treatment you receive.

Every year, about 200 people in Sweden develop amyotrophic lateral sclerosis (ALS). Most of them are between 50 and 70 years old. This disease is incurable and leads to increasing muscle weakness and respiratory failure.

There is treatment available for respiratory failure. But not all patients in Sweden qualify for the most advanced treatment. This is the starting point for the research being conducted by Andreas Palm, chief physician and associate professor at the Academic Hospital in Uppsala.

Andreas Palm, who previously worked at Gävle Hospital and has lived there for 25 years, has begun a study mapping the treatment of respiratory failure in amyotrophic lateral sclerosis (ALS) in Sweden. Among other things, it examines the regional differences that exist when it comes to the use of a home ventilator, a breathing device that can be used at home.

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There are two types of home ventilators. One is a model in which the patient uses a mask that covers the nose and sometimes also the mouth. The other is called invasive ventilator therapy and means that through a tracheostomy, which is a hole in the throat, the patient is given breathing support.

The latter method can be more effective and contribute to the patient living longer. But it is used much less in Sweden than in many similar countries.

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Even within Sweden there are differences. Some areas are more positive about treatment than others. Gävleborg belongs to the regions where the invasive method is not used.

– It is a problem if the accommodation is to control how respiratory failure in ALS is treated. We do not know the extent of regional differences. This is what we will discover in the study, says Andreas Palm.

Andreas Palm, senior physician and associate professor at the University Hospital in Uppsala.  Photo: private

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Why is Swedish health care generally limited in offering surgical treatment for respiratory failure?

-We are talking about ancient doctrines. During their training, doctors learned that it was wrong to put ALS patients on ventilators. Andreas Palm says that these doctrines are worth relaxing.

Do you think more people should receive treatment?

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– Yes, I think more people will benefit from it. It significantly improves survival in patients suitable for it. But I want to stress that it is not for everyone. Some people suffer from a disease that progresses very quickly, such as Boris Salming, in which case this treatment is of no use. Others suffer from complications of different types, such as dementia, for example, and therefore it is not a good treatment either.

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Isn't it easy to start a treatment like this at home?

– No, the patient gets a hole in the neck and takes a long time in the hospital before she can go home. You have to train the staff and make sure everything is adapted. There will also be great pressure on relatives who have to step in and become active carers. There are many obstacles on the way. This may be a reason to refrain from providing this treatment.

Andreas Palm received SEK 1.5 million from the Heart and Lung Foundation for his study on the treatment of respiratory failure in amyotrophic lateral sclerosis.