Impact of invasive ventilation on survival when non-invasive ventilation is ineffective in patients with Duchenne muscular dystrophy: A prospective cohort

Boussaïd, Ghilas; Lofaso, Frédéric; Santos, Dante Brasil; Vaugier, Isabelle; Pottier, Sandra; Prigent, Hélène; Bahrami, Stéphane; David, Olivier

doi:10.1016/j.rmed.2016.04.009

Cited by 23 publications

(30 citation statements)

References 38 publications

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“…No papers had a nonexposed cohort for comparison, and only 19 controlled for or explored associations between liberation and/or mortality and other clinically meaningful factors. 2,4,5,15,17,[19][20][21][22][23][24][25][26][27][28][29][30][31][32] The ratings of in- Table 1). Forty-two (32%) papers studied patients who were initiated solely on IV; 45 (35%) papers studied patients who were initiated solely on NIV.…”

Section: Resultsmentioning

confidence: 99%

Liberation and mortality outcomes in pediatric long‐term ventilation: A qualitative systematic review

Foy

Koncicki

Edwards

2020

Pediatric Pulmonology

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Objective: To provide a systematic review of liberation from positive pressure ventilation and mortality of children with chronic respiratory failure who used long-term invasive and noninvasive ventilation (LTV). Methods: Papers published from 1980 to 2018 were identified using Pubmed MEDLINE, Ovid MEDLINE, Embase, and Cochrane databases. Search results were limited to English-language papers with (a) patients less than 22 years at initiation, (b) patients who used invasive ventilation (IV) via tracheostomy or noninvasive ventilation (NIV), and (c) data on mortality or liberation from LTV. Data were presented using descriptive statistics; changes in outcomes over time were explored using linear regression. Follow-up variability, cohort heterogeneity, and insufficient data precluded combining data to estimate incidences or rates. Results: One hundred and thirty papers with 12 704 patients were included. The median number of patients was 37 (interquartile range [IQR] 17-74, range 6-3802). Twenty-five percent of patients were initiated on IV; 75% on NIV. The maximum follow-up ranged from 0.5 to 31.8 years (median 8.8 years). The median proportion of patients liberated in these papers was 3% (IQR 0%-21%). The median proportion of mortality was 18% (IQR 8%-27%). Proportions of liberation and mortality did not significantly change over time. Progression of underlying disease (44%), respiratory illness (19%), and LTV accident (11%) were the most common causes of death. Conclusions: These papers collectively show most patients survive for many years using LTV; in many subgroups, death is a more common outcome than liberation. However, the limitations of these papers preclude robust prognostication.

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Section: Resultsmentioning

confidence: 99%

Liberation and mortality outcomes in pediatric long‐term ventilation: A qualitative systematic review

Foy

Koncicki

Edwards

2020

Pediatric Pulmonology

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“…However, when desaturation occurs, despite the use of both techniques, or bulbar muscular impairment is too advanced and the patient is unable to protect the airways, tracheostomy and invasive mechanical ventilation (IMV) should be considered in both ALS and DMD [132, 133]. The capability to initiate and to monitor NIV 24 h/day is often a prerogative of tertiary centers where expert teams of physicians are involved in the care of NMD patients with often remarkable results [134].…”

Section: Ethical Dilemmasmentioning

confidence: 99%

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

Crimi

Pierucci²,

Carlucci

et al. 2019

Respiration

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Background: Noninvasive mechanical ventilation (NIV) is an effective treatment in patients with neuromuscular diseases (NMD) to improve symptoms, quality of life, and survival. Summary: 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. Key Message: 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.

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“…There are variable opinions regarding whether DMD patients should be ventilated noninvasively via mask (NIV) or invasively via tracheostomy (IV). Boussaid et al studied DMD patients followed at their large referral center for neuromuscular disease, assessing the relationship between NIV, IV, and survival. The study population consisted of 150 DMD patients on home mechanical ventilation for at least 6 h per day during the time period 1997‐2014.…”

Section: Neuromuscular Diseasementioning

confidence: 99%

Pediatric Pulmonologyyear in review 2016: Part 1

et al. 2017

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Our journal covers a broad range of research and scholarly topics related to children's respiratory disorders. For updated perspectives on the rapidly expanding knowledge in our field, we will summarize the past year's publications in our major topic areas, as well as selected publications in these areas from the core clinical journal literature outside our own pages. The current review covers articles on neonatal lung disease, pulmonary physiology, and respiratory infection.Word count: 71 3

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Impact of invasive ventilation on survival when non-invasive ventilation is ineffective in patients with Duchenne muscular dystrophy: A prospective cohort

Abstract: Switching to invasive ventilation is appropriate when non-invasive ventilation is ineffective.

Cited by 23 publications

References 38 publications

Liberation and mortality outcomes in pediatric long‐term ventilation: A qualitative systematic review

Liberation and mortality outcomes in pediatric long‐term ventilation: A qualitative systematic review

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

Pediatric Pulmonologyyear in review 2016: Part 1

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