Noninvasive respiratory assistance as aid for respiratory care in neuromuscular disorders.
Andrew Graustein, Hugo Carmona, Joshua O Benditt
PMID 37275400WHAT IT FOUND
Noninvasive ventilation and mechanically assisted cough are standard care for chronic respiratory failure in neuromuscular disease, but most timing recommendations rest on expert opinion because trials are lacking.
Key findings
01Noninvasive ventilation and mechanically assisted cough are standard care for chronic respiratory failure due to neuromuscular disease.
02Most recommendations for when to start respiratory assistance are based on expert opinion because randomized trials on timing are lacking.
03Cough assistance is usually recommended when peak cough flow is 270 L/min or less.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for SLPs
Read the rest of this summary
You get three full summaries a month, free, and we do not ask for a card. Search, the TL;DRs and your library stay unlimited either way.
What it does not show
This is a narrative review, not an original study, so it reports no new participants, methods, or outcomes. Most timing recommendations are based on expert opinion because prospective and randomized trials are lacking. Evidence for exercise, using a ventilator during rehabilitation, and respiratory muscle training is heterogeneous, often short-term, and limited by poor reporting of adverse events. Some recommendations reflect reimbursement rules and local resource constraints, not only clinical need. The review covers many neuromuscular diseases with different rates of progression, so advice may not apply equally to every patient.
The easy way to misread this
Do not read this review as proof that specific when-to-start thresholds or ventilator settings are proven by trials. The paper says most recommendations are based on expert opinion because randomized trials are lacking.