Effectiveness of automatic intratracheal suctioning system (AISS) for amyotrophic lateral sclerosis patients with tracheostomy-invasive ventilation

Objective: We performed retrospective hospital-based study to clarify the clinical effectiveness of automatic intratracheal suctioning system (AISS) for amyotrophic lateral sclerosis (ALS) patients with tracheostomy-invasive ventilation (TIV). Background: We provide long-term medical care for neuromuscular disease patients as a neuromuscular-disease center hospital in Hokuriku area of Japan. We have also developed multidisciplinary care team for ALS and we are supporting their own decisionmaking. Partly as a result of our support, about 25% of our ALS patients choose TIV. So, management of ALS-TIV respiratory condition is the important part of our care. To reduce respiratory complications, our respiratory care support team (RST) began to apply AISS since 2012. Design/Methods: To elucidate the clinical effectiveness of AISS, we retrospectively reviewed medical records of ALS-TIV cases and collected vital sign, suction frequency, episode of pneumonia, usage of antibiotics, and reports of RST intervention. Results: We were able to pick up 4 cases of ALS-TIV using AISS. Average duration between TIV starting and AISS introduction was 49.9 months and was distributed from 0.7 to 97 months. We were able to observe each cases after AISS introduction from 7 to 41 months. Average observation period was 22.8 months. The frequency of manual intratracheal suction decreased an average of 78%. Change of vital sign were not remarkable. But two of those 4 cases needed minor correction of the ventilation condition. Conclusions: From this retrospective study, AISS could improve respiratory tract clearance of ALS-TIV patients. Consequently, the frequency of manual intratracheal suction dramatically decreased. So, AISS could have great possibility to improve respiratory conditions of ALS-TIV. Also the systematic RST participation was important for the safe introduction of AISS. Disclosure: Dr. Komai has nothing to disclose. Dr. Tagami has nothing to disclose. Dr. Ishida has nothing to disclose. Dr. Takahashi has nothing to disclose. Dr. Motozaki has nothing to disclose. Dr. Akagi has nothing to disclose. Dr. Ozaki has nothing to disclose. Dr. Shimizu has nothing to disclose.