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Why Is Noninvasive Ventilation (NIV) Recommended for Patients With Neuromuscular Diseases Experiencing Chronic Respiratory Failure?

Duane Reed, EdD, RRT, RCP

September 15, 2023

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Question

Why is noninvasive ventilation (NIV) recommended for patients with neuromuscular diseases experiencing chronic respiratory failure?

Answer

The panel's recommendation of employing non-invasive ventilation aligns logically with this context. However, it is worth highlighting that while clinical indications for non-invasive ventilation are present, they can vary based on factors such as the specific neuromuscular disease, patient age, and the pace of disease progression. In essence, these multifaceted variables influence the suitability of non-invasive ventilation.

The evidence was primarily derived from adults with ALS, given its prevalence as the most common NMD. However, its application should be approached thoughtfully when considering younger children, adolescents, and adults with non-ALS diagnoses. The panel further suggests that its applicability remains subject to these diverse factors even with established indications for non-invasive ventilation. The panel highlights key indicators, such as a decrease in forced vital capacity (FVC) to less than 80% of predicted accompanied by symptoms or an FVC below 50% of predicted symptoms. Similarly, a SNIP or MIP measurement indicative of a reserve of -40 centimeters of water can signify the need for non-invasive ventilation.

The guidelines have transitioned from recommendations and marked a significant development in 2023. Specifically, if a patient's FVC falls below 80% with symptoms or below 50% without symptoms, the situation warrants the implementation of non-invasive ventilation.

This Ask the Expert is an edited excerpt from the course, Respiratory Management of Patients With Neuromuscular Weakness Series: Review Recommendations and Best Practicepresented by presented by Dr. Duane Reed, EdD RRT, RCP.

 


duane reed

Duane Reed, EdD, RRT, RCP

Dr. Duane Reed received his Doctoral degree in Education from Walden University. He completed his Master’s degree in Adult Education from Central Michigan University and his Bachelor’s degree in Advanced Respiratory Care from Weber State University.

Dr. Reed is the respiratory care program director at Southern Crescent Technical College. His clinical experience entails over 20 years as a respiratory care practitioner at Grady Memorial Hospital in Atlanta, Georgia, working in critical care areas of surgical, cardiac, medical, and neurointensive care units. Over the last ten years, Dr. Reed has contributed to educational publishing companies as a clinical editor and senior reviewer.

Additionally, Dr. Reed owns Pulmonary Education Consultants, LLC, a company providing respiratory care educational materials and tutoring services. He has authored study cards in areas of mechanical ventilation, which are nationally published, helping respiratory therapists around the country.


Related Courses

Respiratory Management of Patients With Neuromuscular Weakness Series: Review Recommendations and Best Practice
Presented by Duane Reed, EdD, RRT, RCP
Video

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Duane Reed, EdD, RRT, RCP
Course: #1827Level: Intermediate1 Hour
  'options and diagnostic tools'   Read Reviews
An essential concern in neuromuscular diseases (NMD) is respiratory failure. This course reviews guidelines and evidenced-based literature on the best practice respiratory management of patients with NMD. It is part of an NMD series but can be viewed as a stand-alone learning experience.

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  'I learned a lot about techniques to use on patients with NMD's'   Read Reviews
Clinical experts comprised a multi-professional panel to conduct a systematic review to address patients with neuromuscular diseases (NMD). A review of evidenced-based grading of recommendations and management of patients with NMD is discussed. It is part of an NMD series but can be viewed as a stand-alone learning experience.

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