What does “invasive ventilation therapy” mean in ALS?

Ventilation following a tracheotomy and the use of a tracheal cannula (plastic tube placed in the tracheostoma) and a ventilator is referred to as invasive ventilation. The term “invasive” refers to the need for a tracheotomy and the associated opening of the skin to expose the trachea below the larynx. A surgical procedure is used to create an opening (stoma) inside the windpipe (trachea) (called a tracheostoma). The tracheal cannula is inserted into the tracheostoma and connected to a ventilator via a tube system, which transports the air required for breathing into the lungs. The required ventilation pressures (positive pressure) and air volume (breathing volume) can be regulated on the ventilator.

Invasive ventilation can completely replace the body’s respiratory function. Even if there is a complete loss of strength in the respiratory muscles, invasive ventilation therapy can be used to provide the body with an adequate supply of breathing air. The positive pressure created by the ventilator “replaces” the body’s breathing function, which is why this ventilation therapy is sometimes referred to as “artificial ventilation”. The ability of invasive ventilation to take over the body’s mechanical breathing function means that this treatment can be classified as organ replacement therapy. The organ function of the lungs (at least the mechanical component) is replaced by the ventilator.

Invasive ventilation therapy is considered a life-prolonging measure, as it can prolong life beyond the actual course of the disease.