The effectiveness of non-invasive ventilation in neuromuscular patients in KAMC
More details
Hide details
Respiratory Therapy Department, College Of Applied Medical Sciences, King Saud Bin Abdulaziz University For Health Sciences, Riyadh, Saudi Arabia
Publish date: 2018-08-09
Electron J Gen Med 2018;15(5):em75
The impact of non-invasive ventilation on neuromuscular disease (NMD) has become evident over the past two decades due to frequent use of this technique. It allows some patients with non-progressive pathology to almost live a normal life. The purpose of this study is to indicate the impact of NIV and its results in NMD patients.

The primary objectives for the study were to find the incidence and outcome of NMD patient on NIV, to determine whether NIV can avoid intubation and Mechanical ventilation and to compare vital signs and arterial blood gas parameters before and after NIV.

This retrospective study was conducted during a period from January 2010 to October 2017 in King Abdul-Aziz Medical city (KAMC). The data was collected from Medical Record Department. The collected data got statistically analyzed and results obtained by using SPSS software. A total number of 21 patients admitted in KAMC in adult ICUs, wards, and Emergency room for both males and females with neuromuscular diseases with an age above 18 years old were included. Parameters related to patients and NIV were collected and recorded in an excel sheet and there by SPSS software.

A total of 21 patients enrolled in this study. There were 14 males and 7 females. The minimum age 19 years old and the maximum 81 years old with a mean age of 45. Arterial Blood Gas done Pre and Post NIV and compared using paired’t’ test. The pre and post pH on NIV was significant with a P value (p: 0.029). The pre and post PaCO2 on NIV with a P value (P: 0.034) and oxygenation in pre and post NIV with a P value (P: 0.008) was also significant.

In this study, since most of the results indicates poor prognosis, it is difficult to say that NIV improve the quality of life. This can be due to the limitations and bias in the study like the heterogeneity of the diseases and bias can be due to the hospital and its policies.

1. Kacmarek R, Stoller J, Heuer A, Chatburn R, Kallet R. Egan’s fundamentals of respiratory care. 11th ed. St. Louis, Missouri 63043: Elsevier. 2013:655-659. PMCid:PMC4056076.
2. Simonds AK. Recent Advances in Respiratory Care for Neuromuscular Disease. Chest. 2006;130(6):1879-1886. https://doi.org/10.1378/chest.... PMid:17167012.
3. Wokke JHJ, van Doorn PA, Hoogendijk JE, de Visser M, Wokke JHJ, van Doorn PA. Neuromuscular disease. 2nd ed. New York: Cambridge University Press. 2013:95–100.
4. Spitzer AR, Giancarlo T, Maher L, Awerbuch G, Bowles A. Neuromuscular causes of prolonged ventilator dependency. Muscle Nerve. 1992;15(6):682-6. https://doi.org/10.1002/mus.88... PMid:1508233.
5. Hutchinson D, Whyte K. Neuromuscular disease and respiratory failure. Pract Neurol. 2008;8(4):229-37. https://doi.org/10.1136/pn.200... PMid:18644909.
6. Moritz F, Benichou J, Vanheste M. Boussignac continuous positive airway pressure device in the emergency care of acute cardiogenic pulmonary oedema: a randomized pilot study. Eur J Emerg Med. 2003;10(3):204-8. https://doi.org/10.1097/000631... PMid:12972896.
7. Rusterholtz T, Kempf J, Berton C, Gayol S. Noninvasive pressure support ventilation with face mask in patients with acute cardiogenic pulmonary edema (ACPE). Intensive Care Med. 1999;25(1):21-8. https://doi.org/10.1007/s00134... PMid:10051074.
8. Hillberg RE, Johnson DC. Noninvasive ventilation. N Engl J Med. 1997;11;337(24):1746-52.
9. Lisboa, C, Díaza, O, Fadicb R. Noninvasive mechanical ventilation in patients with neuromuscular diseases and in patients with chest restriction. Archivos de Bronconeumología (English Edition). Arch Bronconeumol. 2003;39(7):314-20. https://doi.org/10.1016/S0300-... PMid:12846961.
10. Stevens R, Marshall S, Cornblath D, Hoke A, Needham D, de Jonghe B. A framework for diagnosing and classifying intensive care unit-acquired weakness. Crit Care Med. 2009;37(10):299-308. https://doi.org/10.1097/CCM.0b... PMid:20046114.
11. Mehta S. Neuromuscular disease causing acute respiratory failure. Respir Care. 2006;51(9):1016-21. PMid:16934165.
12. Eagle M, Baudouin SV, Chandler C, Giddings DR. Survival in Duchenne muscular dystrophy: improvements in life expectancy since 1967 and the impact of home nocturnal ventilation. Acta Myol. 2012;31(2):121–125.
13. de Vries J, Hagemans M, Bussmann J, van der Ploeg A, van Doorn P. Fatigue in neuromuscular disorders: focus on Guillain–Barré syndrome and Pompe disease. Cell Mol Life Sci. 2010;67(5):701–713. https://doi.org/10.1007/s00018... PMid:20196238 PMCid:PMC2824125.
14. O. Benditt J, J. Boitano L. Pulmonary Issues in Patients with Chronic Neuromuscular Disease: American Journal of Respiratory and Critical Care Medicine. ATS Journals. 2013;187(10).
15. Baudouin S, Blumenthal S, Cooper B. Non-invasive ventilation in acute respiratory failure. Thorax. 2002;57(3):192-211. https://doi.org/10.1136/thorax... PMCid:PMC1746282.
16. V Lightowler J, A Wedzicha J, W Elliott M. Papers Non-invasive positive pressure ventilation to treat respiratory failure resulting from pulmonary disease. BMJ. 2003;326(7382):185. https://doi.org/10.1136/bmj.32....
17. Cabrera Serrano M, Rabinstein AA. Causes and outcomes of acute neuromuscular respiratory failure. Arch Neurol. 2010;67(9):1089-1094. https://doi.org/10.1001/archne... PMid:20837853.
18. Radunovic A, Annane D, Jewitt K, Mustfa N.Mechanical ventilation for amyotrophic lateral sclerosis/motor neuron disease. Cochrane Database Syst Rev. 2009;(4).
19. Bourke SC, Bullock RE, Williams TL, Shaw PJ, Gibson GJ. Effects of non-invasive ventilation on survival and quality of life in patients with amyotrophic lateral sclerosis: a randomised controlled trial. Lancet Neurol. 2006;5(2):140-7. https://doi.org/10.1016/S1474-....
20. Ambrosino N, Carpene N, Gherardi M. Chronic respiratory care for neuromuscular diseases in adults. Eur Respir J. 2009;34(2):444-51. https://doi.org/10.1183/090319... PMid:19648521.
21. Katz S, Selvadurai H, Keilty K, Mitchell M, MacLusky I. Outcome of non-invasive positive pressure ventilation in paediatric neuromuscular disease. Archives of Disease in Childhood. 2004;89(2):121-124. https://doi.org/10.1136/adc.20....