Respiratory adjuncts to NIV in neuromuscular disease

ABSTRACTMuscle weakness is an intrinsic feature of neuromuscular diseases (NMD). When the respiratory muscles are involved, the ability to take a deep breath is compromised, leading to reduced lung volumes and a restrictive ventilatory impairment. Inspiratory, expiratory and bulbar muscle weakness can also impair cough, which may impede secretion clearance. Non ‐invasive ventilation (NIV) is an established and indispensable therapy to manage hypoventilation and respiratory failure. The role of other therapies that support respiratory health is less clearly defined, and the evidence of efficacy is also harder to summarize as the underlying data are of a l esser quality. This narrative review appraises the evidence for respiratory therapies in adults with NMD and respiratory system involvement. Techniques that assist lung inflation and augment cough, such as lung volume recruitment (LVR) and mechanical insufflation‐exsufflation (MI‐E), are a parti cular focus of this review. The evidence suggests that LVR, MI‐E and various combinations thereof have clinical utility generally, but important methodological limitations limit the strength of clinical recommendations and hamper the integration of evidence into practice. Future trials should pros pectively assess the long‐term impact of LVR and cough augmentation on clinical outcomes and burden of care in addition to lung mechanics, as well as determine clear predictors of benefit from these techniques.
Source: Respirology - Category: Respiratory Medicine Authors: Tags: Invited Review Series: Non ‐invasive ventilation Source Type: research

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Source: TIME: Health - Category: Consumer Health News Authors: Tags: Uncategorized China Infectious Disease onetime overnight Source Type: news
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Source: TIME: Health - Category: Consumer Health News Authors: Tags: Uncategorized China Infectious Disease onetime overnight Source Type: news
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Source: Journal of Ethnopharmacology - Category: Drugs & Pharmacology Source Type: research
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Source: WBZ-TV - Breaking News, Weather and Sports for Boston, Worcester and New Hampshire - Category: Consumer Health News Authors: Tags: Boston News Health CNN Coronavirus Source Type: news
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Source: Los Angeles Times - Science - Category: Science Source Type: news
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Source: The Lancet - Category: General Medicine Source Type: research
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