Daytime noninvasive ventilatory support for patients with ventilatory pump failure: a narrative review

Multidisciplinary Respiratory Medicine, 2019 · DOI: https://doi.org/10.1186/s40248-019-0202-7 · Published: October 31, 2019

Pulmonology Neurology

Simple Explanation

This review discusses using noninvasive ventilation (NIV) to help patients with weak respiratory muscles during the day. NIV can provide full ventilatory support, serving as an alternative to tracheostomy mechanical ventilation. The review aims to examine the techniques used for daytime support, highlighting methods for providing continuous noninvasive ventilatory support (CNVS). CNVS can improve gas exchange, quality of life, and decrease pneumonia incidence, supporting life indefinitely without tracheotomy.

Study Duration

Not specified

Participants

Not specified

Evidence Level

Level 5: Narrative Review

Key Findings

1
Daytime NVS is crucial for patients with advanced ventilatory pump failure to avoid acute on chronic respiratory failure and invasive airway tubes.
2
Interfaces and access to mechanical in-exsufflation play key roles for NVS success.
3
Glossopharyngeal breathing can also be a very effective means of daytime ventilatory support.

Research Summary

This review examines daytime noninvasive ventilatory support (NVS) techniques for patients with ventilatory pump failure, offering an alternative to tracheostomy mechanical ventilation. Key methods include mouthpiece and nasal NVS, intermittent abdominal pressure ventilation, negative-pressure ventilation, glossopharyngeal breathing, and mechanical insufflation-exsufflation. Daytime NVS is critical for avoiding acute respiratory failure, with interfaces and mechanical in-exsufflation playing key roles; further research is warranted to improve patient outcomes.

Practical Implications

Improved Patient Outcomes

Daytime NVS can significantly improve the quality of life and survival for patients with ventilatory pump failure by avoiding invasive procedures like tracheostomies.

Clinical Practice

Clinicians should consider incorporating daytime NVS techniques, including mouthpiece ventilation and mechanical in-exsufflation, into their treatment plans for patients with neuromuscular diseases.

Future Research

Further research is needed to optimize NVS techniques and explore the role of body ventilators and glossopharyngeal breathing in daytime respiratory support.

Study Limitations

1
Paucity of literature focused on daytime NVS.
2
Effectiveness of intermittent abdominal pressure ventilation depends on chest and abdomen surface area.
3
Negative pressure body ventilators can cause severe obstructive apneas during sleep.

Your Feedback

Was this summary helpful?

Back to Pulmonology