Tracheostomy tubes are not needed for Duchenne muscular dystrophy

Respiratory Outcomes of Patients With Amyotrophic Lateral Sclerosis: An Italian Nationwide Survey

“…Limiting the use of tracheostomy ventilation in patients with a not rapidly progressive NMD is in accordance with expert opinion that tracheostomy is needed only in individuals with severe loss of bulbar muscle control and inability to protect the airway from aspiration. 37,38 Based on our data, in totally ventilator-dependent patients with preserved bulbar function, 24-hour NIV via mouthpiece is not considered a viable option, probably due to inadequate team experience. Our survey shows evidence of close cooperation among pulmonologists, neurologists, and physiatrists.…”

Home mechanical ventilation in children is feasible in developing countries

“…In patients with NMD, NIV results in reduction of symptoms, hospitalizations, and health care costs, without adversely effecting quality of life 20 . Invasive ventilation should be considered when NIV is not possible due to bulbar weakness or loss of motivation to continue NIV 21,22 . Nevertheless, NIV and assisted coughing with cardioprotective medication can result in a more favorable outcome than does invasive treatment 23 …”

“…20 Invasive ventilation should be considered when NIV is not possible due to bulbar weakness or loss of motivation to continue NIV. 21,22 Nevertheless, NIV and assisted coughing with cardioprotective medication can result in a more favorable outcome than does invasive treatment. 23 The only clear indication for initiation of NIV is daytime hypercapnia.…”

Efficacy and comfort of volume‐guaranteed pressure support in patients with chronic ventilatory failure of neuromuscular origin

“…Long‐term non‐invasive mechanical ventilation (NIV) is a well‐established procedure for the treatment of chronic respiratory failure due to neuromuscular disease (NMD) 1–3 . NIV significantly improves survival and is a viable option for patients who cannot be treated by tracheostomy 4–6 . However, patients with NMD represent a population with peculiar requirements, because in most cases their need for NIV progressively increases to 24 h/day; in this setting, maintenance of effective ventilation and ensuring the comfort of the patient are of critical importance.…”