Extubation of Patients With Neuromuscular Weakness

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Extubation of patients with neuromuscular weakness: a new management paradigm.

BACKGROUND Successful extubation conventionally necessitates the passing of spontaneous breathing trials (SBTs) and ventilator weaning parameters. We report successful extubation of patients with neuromuscular disease (NMD) and weakness who could not pass them. METHODS NMD-specific extubation criteria and a new extubation protocol were developed. Data were collected on 157 consecutive "unwean...

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Extubation of patients with neuromuscular weakness: a routine step or a challenging procedure?

We read with great interest the article by Bach et al 1 in a recent issue of CHEST (May 2010) concerning the application of continuous volume-cycled noninvasive ventilation (NIV) and mechanically assisted coughing (MAC) to successfully extubate patients with neuromuscular disease (NMD) after an episode of acute respiratory failure (ARF). In fact, considering that extubation failure is associate...

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Neuromuscular disease and extubation dysphagia

Post-extubation dysphagia is a common and serious problem. The presence of neuromuscular disease at the time of intubation is likely to increase this. Until recently, the prevalence and the association with length of intubation had not been clarified. Results published in this journal suggest that 93% of extubated patients with neuromuscular disease had post-extubation dysphagia, which in 33% o...

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Airway clearance in neuromuscular weakness.

Impaired airway clearance leads to recurrent chest infections and respiratory deterioration in neuromuscular weakness. It is frequently the cause of death. Cough is the major mechanism of airway clearance. Cough has several components, and assessment tools are available to measure the different components of cough. These include measuring peak cough flow, respiratory muscle strength, and inspir...

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ژورنال

عنوان ژورنال: Chest

سال: 2010

ISSN: 0012-3692

DOI: 10.1378/chest.10-1086