Risk of unsuccessful noninvasive ventilation for acute respiratory failure in heterogeneous neuromuscular diseases: a retrospective study

  • Hiroshi Kataoka | hk55@naramed-u.ac.jp Department of Neurology, Nara Medical University, Kashihara, Japan.
  • Hitoki Nanaura Department of Neurology, Nara Medical University, Kashihara, Japan.
  • Kaoru Kinugawa Department of Neurology, Nara Medical University, Kashihara, Japan.
  • Yuto Uchihara Department of Neurology, Nara Medical University, Kashihara, Japan.
  • Hiroya Ohara Department of Neurology, Nara Medical University, Kashihara, Japan.
  • Nobuyuki Eura Department of Neurology, Nara Medical University, Kashihara, Japan.
  • Ryogo Syobatake Department of Neurology, Nara Medical University, Kashihara, Japan.
  • Nobuhiro Sawa Department of Neurology, Nara Medical University, Kashihara, Japan.
  • Kiriyama Takao Department of Neurology, Nara Medical University, Kashihara, Japan.
  • Kazuma Sugie Department of Neurology, Nara Medical University, Kashihara, Japan.
  • Satoshi Ueno Department of Neurology, Nara Medical University, Kashihara, Japan.

Abstract

If invasive ventilation can be avoided by performing noninvasive mechanical ventilation (NIV) in patients with acute respiratory failure (ARF), the disease can be effectively managed. It is important to clarify the characteristics of patients with neuromuscular diseases in whom initial NIV is likely to be unsuccessful. We studied 27 patients in stable neuromuscular condition who initially received NIV to manage fatal ARF to identify differences in factors immediately before the onset of ARF among patients who receive continuous NIV support, patients who are switched from NIV to invasive ventilation, and patients in whom NIV is discontinued. Endpoints were evaluated 24 and 72 hours after the initiation of NIV. After 24 hours, all but 1 patient with amyotrophic lateral sclerosis (ALS) received continuous NIV support. 72 hours later, 5 patients were switched from NIV to invasive ventilation, and 5 patients continued to receive NIV support. 72 hours after the initiation of NIV, the proportion of patients with a diagnosis of ALS differed significantly among the three groups (P=0.039). NIV may be attempted to manage acute fatal respiratory failure associated with neuromuscular diseases, but clinicians should carefully manage the clinical course in patients with ALS.

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Published
2017-03-28
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Keywords:
Noninvasive mechanical ventilation, Acute respiratory failure, Amyotrophic lateral sclerosis, Risk
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How to Cite
Kataoka, H., Nanaura, H., Kinugawa, K., Uchihara, Y., Ohara, H., Eura, N., Syobatake, R., Sawa, N., Takao, K., Sugie, K., & Ueno, S. (2017). Risk of unsuccessful noninvasive ventilation for acute respiratory failure in heterogeneous neuromuscular diseases: a retrospective study. Neurology International, 9(1). https://doi.org/10.4081/ni.2017.6904