Respiratory complications of amyotrophic lateral sclerosis

Amyotrophic lateral sclerosis (ALS) is a progressive and fatal neurodegenerative disease that inevitably affects the respiratory system, and part of its treatment focuses on improving symptoms and minimizing its respiratory complications which are the main cause of death; thus, the purpose of the following review is to describe the pulmonary involvement of ALS, to propose diagnostic/monitoring guidelines, and to expose its therapeutic options. The alveolar hypo ventilation syndrome and the poor management of bronchial secretion are the main respiratory difficulties secondary to ALS and they are due to the weakness of the muscles that generate respiration; in this way, the periodic assessment of respiratory function is imperative for monitoring and detecting these complications in early stages. The care of patients with ALS should be multidisciplinary and ideally should be performed in specialized centers; non-invasive mechanical ventilation and assisted cough (manual or mechanical) are the two most cost/effective techniques to treat alveolar hypoventilation and poor secretion management to increase survival, improve symptoms, and increase quality of life.