6533b838fe1ef96bd12a3e6c

RESEARCH PRODUCT

Long-Term Ventilation in Neuromuscular Patients: Review of Concerns, Beliefs, and Ethical Dilemmas

Claudia CrimiAndrea CortegianiCesare GregorettiPaola PierucciAnnalisa Carlucci

subject

Duchenne muscular dystrophyPulmonary and Respiratory MedicineRespiratory Therapymedicine.medical_specialtyTelemedicineTime FactorsPalliative caremedicine.medical_treatmentNeuromuscular disorderHome care03 medical and health sciencesTracheostomy0302 clinical medicineQuality of life (healthcare)Health caremedicineRespiratory muscleHumansIn patient030212 general & internal medicineIntensive care medicineAmyotrophic lateral sclerosiAmyotrophic lateral sclerosis; Duchenne muscular dystrophy; Home care; Neuromuscular disorders; Noninvasive ventilation; TracheostomyMechanical ventilationbusiness.industryNeuromuscular DiseasesAmyotrophic lateral sclerosisRespiration Artificial030228 respiratory systemQuality of LifeRespiratory InsufficiencybusinessNoninvasive ventilationNeuromuscular disordersFollow-Up StudiesLong term ventilation

description

<b><i>Background:</i></b> Noninvasive mechanical ventilation (NIV) is an effective treatment in patients with neuromuscular diseases (NMD) to improve symptoms, quality of life, and survival. <b><i>Summary:</i></b> NIV should be used early in the course of respiratory muscle involvement in NMD patients and its requirements may increase over time. Therefore, training on technical equipment at home and advice on problem solving are warranted. Remote monitoring of ventilator parameters using built-in ventilator software is recommended. Telemedicine may be helpful in reducing hospital admissions. Anticipatory planning and palliative care should be carried out to lessen the burden of care, to maintain or withdraw from NIV, and to guarantee the most respectful management in the last days of NMD patients’ life. <b><i>Key Message:</i></b> Long-term NIV is effective but challenging in NMD patients. Efforts should be made by health care providers in arranging a planned transition to home and end-of-life discussions for ventilator-assisted individuals and their families.

yearjournalcountryeditionlanguage
2019-01-01Respiration
https://doi.org/10.1159/000495941