![]() Therefore, when considering anesthetic management in patients with ALS, careful monitoring and appropriate drug selection is necessary because the likelihood of emergency situations occurring is higher than that in healthy patients. This may lead to a decrease in general condition and a higher risk of aspiration pneumonia due to dysphagia, an exaggerated change in the response to muscle relaxants, and delayed recovery of spontaneous breathing after general anesthesia, among other adverse side effects. As ALS progresses, atrophy and weakness may affect most skeletal muscles, including the diaphragm, costal muscles, and those of the pharynx and larynx. This results in progressive asymmetric limb weakness and bulbar symptoms such as dysarthria (difficulty in speaking), dysphagia (difficulty in swallowing), and eventually respiratory muscle weakness (difficulty in breathing). The progressive degeneration of motor neurons causes symptoms of muscular weakness, lack of coordination, atrophy, fasciculations, spasticity, and hyperreflexia. Īmyotrophic lateral sclerosis (ALS), also known as Lou Gehrig's disease, is a disease that is characterized by progressive degeneration of all levels of the motor nervous system. The typical treatment approach is to initiate cardiopulmonary resuscitation (CPR) immediately and to identify and treat the underlying cause. PEA is always caused by a profound cardiovascular insult (e.g., severe prolonged hypoxia or acidosis, extreme hypovolemia, or flow-restricting pulmonary embolus). PEA is found initially in about 55% of people in cardiac arrest and occurs when a major cardiovascular, respiratory, or metabolic derangement results in the inability of cardiac muscle to generate sufficient force in response to electrical depolarization. ![]() Pulseless electrical activity (PEA), also known as electromechanical dissociation, is a clinical condition characterized by unresponsiveness and lack of a palpable pulse in the presence of organized cardiac electrical activity. ![]()
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