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Preference of neuromuscular patients regarding equipment for daytime mouthpiece ventilation: A randomized crossover study.
Toussaint, Michel; Chatwin, Michelle; Verhulst, Stijn; Reychler, Gregory.
  • Toussaint M; Centre for Home Mechanical Ventilation and Neuromuscular Disorders, Department of Rehabilitation, Rehabilitation Hospital Inkendaal, Vlezenbeek, Belgium.
  • Chatwin M; Clinical and Academic Department of Sleep and Breathing, Royal Brompton Hospital, S Foundation Trust, Royal Brompton & Harefield NH, London, UK.
  • Verhulst S; Department of Pediatrics, Antwerp University Hospital and Lab of Experimental Medicine and Pediatrics, University of Antwerp, Antwerp, Belgium.
  • Reychler G; Institut de Recherche Expérimentale et Clinique (IREC), Université Catholique de Louvain, Pôle de Pneumologie, ORL & Dermatologie, Brussels, Belgium.
Clin Respir J ; 14(3): 214-221, 2020 Mar.
Article in English | MEDLINE | ID: covidwho-1455532
ABSTRACT

BACKGROUND:

Patients with neuromuscular disorders (NMDs) are likely to develop respiratory failure which requires noninvasive ventilation (NIV). Ventilation via a mouthpiece (MPV) is an option to offer daytime NIV.

OBJECTIVES:

To determine the preferred equipment for MPV by patients with NMDs.

METHODS:

Two MPV equipment sets were compared in 20 patients with NMDs. Set 1, consisted of a non-dedicated ventilator for MPV (PB560, Covidien) with a plastic angled mouthpiece. Set 2, consisted of a dedicated MPV ventilator (Trilogy 100, Philips Respironics) without backup rate and kiss trigger combined with a silicone straw mouthpiece. The Borg dyspnea score, ventilator free time, transcutaneous oxygen saturation (SpO2) and carbon dioxide tension (TcCO2 ) were recorded with and without MPV. Patient perception was assessed by a 17-items list.

RESULTS:

Carbon dioxide tension measurements and total perception score were not different between the two MPV sets. Dyspnea score was lower with the non-dedicated versus dedicated equipment, 1 (0.5) versus 3 (1-6), P < 0.01. All patients with a ventilator free time lower than 6 hours preferred a set backup rate rather than a kiss trigger. Sixty five percent of patients preferred the commercial arm support and 55% preferred the plastic angled mouthpiece.

CONCLUSIONS:

Dedicated and non-dedicated MPV equipment are deemed effective and comfortable. Individualization of arm support and mouthpiece is advised to ensure success of MPV. A ventilator free time lower than 6 hours seems to be a useful indicator to a priori set a backup rate rather than a rate at zero associated to the kiss trigger.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Respiratory Insufficiency / Ventilators, Mechanical / Noninvasive Ventilation / Neuromuscular Diseases Type of study: Diagnostic study / Experimental Studies / Observational study / Prognostic study / Randomized controlled trials Topics: Long Covid Limits: Adolescent / Adult / Female / Humans / Male / Young adult Language: English Journal: Clin Respir J Year: 2020 Document Type: Article Affiliation country: Crj.13118

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Respiratory Insufficiency / Ventilators, Mechanical / Noninvasive Ventilation / Neuromuscular Diseases Type of study: Diagnostic study / Experimental Studies / Observational study / Prognostic study / Randomized controlled trials Topics: Long Covid Limits: Adolescent / Adult / Female / Humans / Male / Young adult Language: English Journal: Clin Respir J Year: 2020 Document Type: Article Affiliation country: Crj.13118