Impact of invasive ventilation on survival when non-invasive ventilation is ineffective in patients with Duchenne muscular dystrophy: A prospective cohort.

Abstract:

BACKGROUND:Many patients with DMD undergo tracheostomy. Tracheostomy is associated with certain complications, however its effect on prognosis is not known. METHODS:The relationship between type of mechanical ventilation and survival at 12 years was evaluated in a prospective cohort of patients with Duchenne muscular dystrophy followed in a French reference center for Neuromuscular Diseases. Cox proportional-hazards regressions were used to estimate the hazard ratios associated with risk of switching from non-invasive to invasive ventilation, and with risk of death. RESULTS:One hundred and fifty patients were included. Initial use of invasive ventilation was associated with an episode of acute respiratory failure (p < 0.0001) and with a severe clinical status (p < 0.05). Risk of death was associated with swallowing disorders (2.51, IC [1.12-5.66], p < 0.03) and cardiac failure (p < 0.05) but not with type of mechanical ventilation. CONCLUSION:Switching to invasive ventilation is appropriate when non-invasive ventilation is ineffective.

journal_name

Respir Med

journal_title

Respiratory medicine

authors

Boussaïd G,Lofaso F,Santos DB,Vaugier I,Pottier S,Prigent H,Bahrami S,Orlikowski D

doi

10.1016/j.rmed.2016.04.009

subject

Has Abstract

pub_date

2016-06-01 00:00:00

pages

26-32

eissn

0954-6111

issn

1532-3064

pii

S0954-6111(16)30066-X

journal_volume

115

pub_type

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