Noninvasive ventilation for neuromuscular respiratory failure: When to use and when to avoid

Research output: Contribution to journalArticle

21 Citations (Scopus)

Abstract

Purpose of review: Neuromuscular respiratory failure can occur from a variety of diseases, both acute and chronic with acute exacerbation. There is often a misunderstanding about how the nature of the neuromuscular disease should affect the decision on how to ventilate the patient. This review provides an update on the value and relative contraindications for the use of noninvasive ventilation in patients with various causes of primary neuromuscular respiratory failure. Recent findings: Myasthenic crisis represents the paradigmatic example of the neuromuscular condition that can be best treated with noninvasive ventilation. Timely use of noninvasive ventilation can substantially reduce the duration of ventilatory assistance in these patients. Noninvasive ventilation can also be very helpful after extubation in patients recovering from an acute cause of neuromuscular respiratory failure who have persistent weakness. Noninvasive ventilation can improve quality of survival in patients with advanced motor neuron disorder (such as amyotrophic lateral sclerosis) and muscular dystrophies, and can avoid intubation when these patients present to the hospital with acute respiratory failure. Attempting noninvasive ventilation is not only typically unsuccessful in patients with Guillain-Barre syndrome, but can also be dangerous in these cases. Summary: Noninvasive ventilation can be very effective to treat acute respiratory failure caused by myasthenia gravis and to prevent reintubation in other neuromuscular patients, but should be used cautiously for other indications, particularly Guillain-Barre syndrome.

Original languageEnglish (US)
Pages (from-to)94-99
Number of pages6
JournalCurrent Opinion in Critical Care
Volume22
Issue number2
DOIs
StatePublished - Apr 1 2016

Fingerprint

Noninvasive Ventilation
Respiratory Insufficiency
Guillain-Barre Syndrome
Neuromuscular Diseases
Muscular Dystrophies
Myasthenia Gravis
Muscle Weakness
Amyotrophic Lateral Sclerosis
Motor Neurons
Acute Disease
Intubation
Chronic Disease
Survival

Keywords

  • Guillain-Barre syndrome
  • mechanical ventilation
  • myasthenia gravis
  • neuromuscular respiratory failure
  • noninvasive ventilation

ASJC Scopus subject areas

  • Critical Care and Intensive Care Medicine

Cite this

Noninvasive ventilation for neuromuscular respiratory failure : When to use and when to avoid. / Rabinstein, Alejandro.

In: Current Opinion in Critical Care, Vol. 22, No. 2, 01.04.2016, p. 94-99.

Research output: Contribution to journalArticle

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