Abstract
Background: A substantial proportion of Neuromuscular Disease (NMD) pts who undergo invasive MV for ARF should be considered at high risk for extubation failure. We prospectively investigated the efficacy of early application of Non-Invasive Ventilation (NIV) combined with Assisted Coughing (AC) as an intervention aimed at preventing extubation failure in NMD pts.
Methods: Prospective analysis of the short-term outcomes of 10 NMD pts who were treated by NIV and AC immediately after extubation (Group A) and comparison with the outcomes of 10 historical control pts who received Standard Medical Treatment (SMT) alone (Group B).
Results: Significantly fewer pts who received the treatment protocol required reintubation and tracheostomy compared with those who received SMT (reintubation: 3 vs 10; tracheostomy: 3 vs 9; p=0.002 and 0.01, respectively). Pts in Group A remained for a shorter time in the RICU compared to Group B (7.8±3.9 vs 23.8±15.8 days; p=0.006).
Conclusions: Preventive application of NIV plus AC after extubation provides an important advantage to NMD pts by averting the need for reintubation or tracheostomy, and shortening their stay in the RICU.
- © 2011 ERS