Skip to main content

Abstract

Respiratory failure is the most common cause of morbidity and mortality in patients with progressive neuromuscular diseases (NMDs) [1–4]. The wide variety of NMDs that can affect respiratory function are listed in Table 32.1. NMDs are often complicated by progressive involvement of the respiratory muscles and can lead to both chronic and acute respiratory failure (ARF). Reduced inspiratory muscle strength can result in ineffective alveolar ventilation, and weakness of expiratory muscles can lead to inadequate clearance of airway secretions. Thus, these conditions can cause chronic respiratory failure as well as potentially life-threatening problems [5–10].

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 109.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 139.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 139.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Mehta S. Neuromuscular disease causing acute respiratory failure. Respir Care. 2006;51(9):1016–21.

    PubMed  Google Scholar 

  2. Hill NS. Neuromuscular disease in respiratory and critical care medicine. Respir Care. 2006;51(9):1065–71.

    PubMed  Google Scholar 

  3. Perrin C, Unterborn JN, Ambrosio CD, et al. Pulmonary complications of chronic neuromuscular diseases and their management. Muscle Nerve. 2004;29(1):5–27.

    Article  PubMed  Google Scholar 

  4. Calvert LD, McKeever TM, Kinnear WJ, et al. Trends in survival from muscular dystrophy in England and Wales and impact on respiratory services. Respir Med. 2006;100(6):1058–63.

    Article  PubMed  CAS  Google Scholar 

  5. Birnkrant DJ, Panitch HB, Benditt JO, et al. American College of Chest Physicians consensus statement on the respiratory and related management of patients with Duchenne muscular dystrophy undergoing anesthesia or sedation. Chest. 2007;132(6):1977–86.

    Article  PubMed  Google Scholar 

  6. Wang CH, Finkel RS, Bertini ES, et al. Consensus statement for standard of care in spinal muscular atrophy. J Child Neurol. 2007;22(8):1027–49.

    Article  PubMed  Google Scholar 

  7. Hull J, Aniapravan R, Chan E, et al. British Thoracic Society guideline for respiratory management of children with neuromuscular weakness. Thorax. 2012;67:i1–40.

    Article  PubMed  Google Scholar 

  8. Bushby K, Finkel R, Birnkrant DJ, et al. Diagnosis and management of Duchenne muscular dystrophy, part 2: implementation of multidisciplinary care. Lancet Neurol. 2010;9(2):177–89.

    Article  PubMed  CAS  Google Scholar 

  9. Wang CH, Bonnemann CG, Rutkowski A, et al. Consensus statement on standard of care for congenital muscular dystrophies. J Child Neurol. 2010;25(12):1559–81.

    Article  PubMed  Google Scholar 

  10. Racca F, Del Sorbo L, Mongini T, et al. Respiratory management of acute respiratory failure in neuromuscular diseases. Minerva Anestesiol. 2010;76(1):51–62.

    PubMed  CAS  Google Scholar 

  11. Benditt JO. Management of pulmonary complications in neuromuscular disease. Phys Med Rehabil Clin N Am. 1998;9(1):167–85.

    PubMed  CAS  Google Scholar 

  12. Bergofsky EH. Respiratory failure in disorders of the thoracic cage. Am Rev Respir Dis. 1979;119(4):643–69.

    PubMed  CAS  Google Scholar 

  13. De Troyer A, Borenstein S, Cordier R. Analysis of lung volume restriction in patients with respiratory muscle weakness. Thorax. 1980;35(8):603–10.

    Article  PubMed  PubMed Central  Google Scholar 

  14. Papastamelos C, Panitch HB, Allen JL. Chest wall compliance in infants and children with neuromuscular disease. Am J Respir Crit Care Med. 1996;154(4):1045–8.

    Article  PubMed  CAS  Google Scholar 

  15. Poponick JM, Jacobs I, Supinski G, Di Marco AF. Effect of upper respiratory tract infection in patients with neuromuscular disease. Am J Respir Crit Care Med. 1997;156(2 Pt 1):659–64.

    Article  PubMed  CAS  Google Scholar 

  16. Tzeng AC, Bach JR. Prevention of pulmonary morbidity for patients with neuromuscular disease. Chest. 2000;118(5):1390–6.

    Article  PubMed  CAS  Google Scholar 

  17. Bach JR, Rajaraman R, Ballanger F, et al. Neuromuscular ventilatory insufficiency: effect of home mechanical ventilator use vs oxygen therapy on pneumonia and hospitalization rates. Am J Phys Med Rehabil. 1998;77(1):8–19.

    Article  PubMed  CAS  Google Scholar 

  18. Simonds AK. Pneumothorax: an important complication of non-invasive ventilation in neuromuscular disease. Neuromuscul Disord. 2004;14(6):351–2.

    Article  PubMed  Google Scholar 

  19. Schmidt-Nowara WW, Altman AR. Atelectasis and neuromuscular respiratory failure. Chest. 1984;85(6):792–5.

    Article  PubMed  CAS  Google Scholar 

  20. Oppenheimer EA. Treating respiratory failure in ALS: the details are becoming clearer. J Neurol Sci. 2003;209:111–3.

    Article  Google Scholar 

  21. Goodwin FC, Muntoni F. Cardiac involvement in muscular dystrophies: molecular mechanisms. Muscle Nerve. 2005;32(5):577–88.

    Article  PubMed  CAS  Google Scholar 

  22. Sveen ML, Thune JJ, Køber L, et al. Cardiac involvement in patients with limb-girdle muscular dystrophy type 2 and Becker muscular dystrophy. Arch Neurol. 2008;65(9):1196–201.

    Article  PubMed  Google Scholar 

  23. Finder JD, Birnkrant D, Carl J, Farber HJ, Gozal D, Iannaccone ST, Kovesi T, Kravitz RM, Panitch H, Schramm C, Schroth M, Sharma G, Sievers L, Silvestri JM, Sterni L, American Thoracic Society. ATS consensus statement respiratory care of the patient with Duchenne muscular dystrophy. Am J Respir Crit Care Med. 2004;170(4):456–65.

    Article  PubMed  Google Scholar 

  24. Racca F, Mongini T, Wolfler A, et al. Recommendations for anesthesia and perioperative management of patients with neuromuscular disorders. Minerva Anestesiol. 2013;79:419–33.

    PubMed  CAS  Google Scholar 

  25. Corrado A, Gorini M, De Paola E. Alternative techniques for managing acute neuromuscular respiratory failure. Semin Neurol. 1995;15(1):84–9.

    Article  PubMed  CAS  Google Scholar 

  26. Servera E, Sancho J, Zafra MJ, et al. Alternatives to endotracheal intubation for patients with neuromuscular diseases. Am J Phys Med Rehabil. 2005;84:851–7.

    Article  PubMed  Google Scholar 

  27. Vianello A, Bevilacqua M, Arcaro G, et al. Non-invasive ventilatory approach to treatment of acute respiratory failure in neuromuscular disorders. A comparison with endotracheal intubation. Intensive Care Med. 2000;26(4):384–90.

    Article  PubMed  CAS  Google Scholar 

  28. Vianello A, Corrado A, Arcaro G, et al. Mechanical insufflation–exsufflation improves outcomes for neuromuscular disease patients with respiratory tract infections. Am J Phys Med Rehabil. 2005;84(2):83–8.

    Article  PubMed  Google Scholar 

  29. Gomez-Merino E, Bach JR. Duchenne muscular dystrophy: prolongation of life by noninvasive ventilation and mechanically assisted coughing. Am J Phys Med Rehabil. 2002;81(6):411–5.

    Article  PubMed  Google Scholar 

  30. Sancho J, Servera E. Noninvasive ventilation for patients with neuromuscular disease and acute respiratory failure. Chest. 2008;133:314–5.

    Article  PubMed  Google Scholar 

  31. Bach JR, Niranjan V, Weaver B. Spinal muscular atrophy type 1: a noninvasive respiratory management approach. Chest. 2000;117(4):1100–5.

    Article  PubMed  CAS  Google Scholar 

  32. Piastra M, Antonelli M, Caresta E, et al. Noninvasive ventilation in childhood acute neuromuscular respiratory failure: a pilot study. Respiration. 2006;73(6):791–8.

    Article  PubMed  CAS  Google Scholar 

  33. Racca F, Appendini L, Berta G, et al. Helmet ventilation for acute respiratory failure and nasal skin breakdown in neuromuscular disorders. Case Report Anesth Analg. (in press). Anesth Analg. 2009;109(1):164–7.

    Google Scholar 

  34. Wang CH, Finkel RS, Bertini ES, et al.; Participants of the International Conference on SMA Standard of Care. Consensus statement for standard of care in spinal muscular atrophy. J Child Neurol. 2007;22(8):1027–49.

    Google Scholar 

  35. Wallgren-Pettersson C, Bushby K, Mellies U, et al. 117th ENMC workshop: ventilatory support in congenital neuromuscular disorders – congenital myopathies, congenital muscular dystrophies, congenital myotonic dystrophy and SMA (II) 4–6 April 2003, Naarden, The Netherlands. Neuromuscul Disord. 2004;14(1):56–69.

    Article  PubMed  Google Scholar 

  36. British Thoracic Society Standards of Care Committee. Non-invasive ventilation in acute respiratory failure. Thorax. 2002;57(3):192–211.

    Article  Google Scholar 

  37. Mehta S, Hill NS. State of the art: noninvasive ventilation. Am J Respir Crit Care Med. 2001;163:540–77.

    Article  PubMed  CAS  Google Scholar 

  38. Bradley MD, Orrell RW, Clarke J, et al. Outcome of ventilatory support for acute respiratory failure in motor neuron disease. J Neurol Neurosurg Psychiatry. 2002;72(6):752–6.

    Article  PubMed  CAS  PubMed Central  Google Scholar 

  39. Bach JR, Bianchi C, Aufiero E. Oximetry and indications for tracheotomy for amyotrophic lateral sclerosis. Chest. 2004;126(5):1502–7.

    Article  PubMed  Google Scholar 

  40. Vianello A, Savoia F, Pipitone E, et al. “Hospital at home” for neuromuscular disease patients with respiratory tract infection: a pilot study. Respir Care. 2013;58(12):2061–8.

    Article  PubMed  Google Scholar 

  41. Vicken W, Elleker G, Cosio MG. Detection of upper airway muscle involvement in neuromuscular disorders using the flow-volume loop. Chest. 1986;90(1):52–7.

    Article  Google Scholar 

  42. Lechtzin N, Wienner CM, Clawson L, et al. Hospitalization in amyotrophic lateral sclerosis: causes, costs, and outcomes. Neurology. 2001;56(6):753–7.

    Article  PubMed  CAS  Google Scholar 

  43. Polkey MI, Lyall RA, Green M, et al. Expiratory muscle function in amyotrophic lateral sclerosis. Am J Respir Crit Care Med. 1998;158(3):734–41.

    Article  PubMed  CAS  Google Scholar 

  44. Padman R, Lawless S, Von Nessen S. Use of BiPAP by nasal mask in the treatment of respiratory insufficiency in pediatric patients: preliminary investigation. Pediatr Pulmonol. 1994;17(2):119–23.

    Article  PubMed  CAS  Google Scholar 

  45. Sancho J, Servera E, Dıaz J, Marin J. Efficacy of mechanical in-exsufflation in medically stable patients with amyotrophic lateral sclerosis. Chest. 2004;125(4):1400–5.

    Article  PubMed  Google Scholar 

  46. Niranjan V, Bach JR. Noninvasive management of pediatric neuromuscular ventilatory failure. Crit Care Med. 1998;26(12):2061–5.

    Article  PubMed  CAS  Google Scholar 

  47. Bach JR, Ishikawa Y, Kim H. Prevention of pulmonary morbidity for patients with Duchenne muscular dystrophy. Chest. 1997;112(4):1024–8.

    Article  PubMed  CAS  Google Scholar 

  48. Bach JR. Update and perspective on noninvasive respiratory muscle aids: Part 2: the expiratory aids. Chest. 1994;105(5):1538–44.

    Article  PubMed  CAS  Google Scholar 

  49. Miske LJ, Hickey EM, Kolb SM, et al. Use of the mechanical inexsufflator in pediatric patients with neuromuscular disease and impaired cough. Chest. 2004;125:1406–12.

    Article  PubMed  Google Scholar 

  50. Chatwin M, Ross E, Hart N, et al. Cough augmentation with mechanical insufflation/exsufflation in patients with neuromuscular weakness. Eur Respir J. 2003;21(3):502–8.

    Article  PubMed  CAS  Google Scholar 

  51. Fauroux B, Guillemot N, Aubertin G, et al. Physiologic benefits of mechanical insufflation-exsufflation in children with neuromuscular diseases. Chest. 2008;133:161–8.

    Article  PubMed  Google Scholar 

  52. Bach JR, Goncalves MR, Hamdani I, et al. Extubation of patients with neuromuscular weakness: a new management paradigm. Chest. 2010;137(5):1033–9.

    Article  PubMed  Google Scholar 

  53. Racca F, Del Sorbo L, Capello E, et al. Neuromuscular patients as candidates for non invasive ventilation during the weaning process. Minerva Anestesiol. 2012;78:391.

    PubMed  CAS  Google Scholar 

  54. Simonds AK. Streamlining weaning: protocols and weaning units. Thorax. 2005;60:175–82.

    Article  PubMed  CAS  PubMed Central  Google Scholar 

  55. Epstein SK. Extubation failure: an outcome to be avoided. Crit Care. 2004;8:310–2.

    Article  PubMed  PubMed Central  Google Scholar 

  56. Vianello A, Arcaro G, Braccioni F, et al. Prevention of extubation failure in high-risk neuromuscular disease patients. J Crit Care. 2011;26(5):517–24.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Fabrizio Racca MD .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2016 Springer International Publishing Switzerland

About this chapter

Cite this chapter

Racca, F., Robba, C., Dusio, M.P. (2016). Noninvasive Mechanical Ventilation in Patients with Neuromuscular Disease. In: Esquinas, A. (eds) Noninvasive Mechanical Ventilation and Difficult Weaning in Critical Care. Springer, Cham. https://doi.org/10.1007/978-3-319-04259-6_32

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-04259-6_32

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-04258-9

  • Online ISBN: 978-3-319-04259-6

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics