Intermittent Positive Pressure Ventilation via the Mouth as an Alternative to Tracheostomy for 257 Ventilator Users

Mais do que bons pulmões!

“…Air stacking as part of the assisted cough technique effectively achieves sufficient PCFs to improve clearance of airway secretions in patients with severe impairment of inspiratory and expiratory muscles, (1)(2)(3) a fact that was also noted by Brito et al, in a study published in this issue of the Brazilian Journal of Pulmonology. (8) In most patients with neuromuscular diseases (with the exception of very young children, who are unable to cooperate, and patients with amyotrophic lateral sclerosis and bulbar muscle involvement), the maneuvers that aim to increase PCFs can achieve values higher than 160 L/min.…”

“…Competent and charismatic, Dr. Bach applies various techniques for respiratory support and for preventing the accumulation of secretions; he has demonstrated the effectiveness of these techniques in various studies. (1)(2)(3) He is the author of the aphorism that states that patients with neuromuscular diseases die not because they cannot breathe, but because they cannot cough properly.…”

Mouthpiece Ventilation: Just a Home-Care Support?

“…It was proposed many years ago in the home-care setting to treat chronic respiratory failure in neuromuscular diseases, especially in North America. [15][16][17] The use of mouthpiece ventilation was reported for the first time at a conference on post-poliomyelitis respiratory equipment in 1953. 18 The author observed that an intermittent positive-pressure ventilator with a mouthpiece circuit could be used to relieve dyspnea in ventilator-dependent polio subjects when switched from negative-pressure ventilation to spontaneous breathing for nursing care or physical therapy.…”

Data Downloads for Effective Noninvasive Ventilation in Patients With Neuromuscular Respiratory Failure

“…Although discussion of these complementary therapies is beyond the scope of this paper, the importance of complete respiratory care and follow-up in these patients cannot be over-emphasized. 14,17,18,21,22 The patient has still not required a tracheostomy, more than 7 years after it was originally recommended.…”