Volume-assured pressure support mode for noninvasive ventilation: can it improve overnight adherence in children with neuromuscular disease?

Neuralgic Amyotrophy (NA) is a rare, acute onset inflammatory brachial plexopathy that frequently presents with acute pain followed by shoulder girdle muscle weakness. Phrenic nerve involvement affecting the diaphragms occurs in 7-10% of cases. We present the case of a 52-year-old man with neuralgic amyotrophy with phrenic nerve involvement and bilateral diaphragmatic paralysis with marked respiratory symptoms and sleep hypoventilation, who was treated with non-invasive ventilation with volume assured pressure support mode. By 21 months post disease onset, the patient had experienced marked improvement in orthopnea, sleep quality and functional status. This is the first reported case of the use of this mode of noninvasive ventilation in neuralgic amyotrophy.

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Noninvasive ventilation via bilevel positive airway pressure support in pediatric practice

Critical Care Medicine ◽

10.1097/00003246-199801000-00034 ◽

1998 ◽

Vol 26 (1) ◽

pp. 169-173 ◽

Cited By ~ 120

Author(s):

Raj Padman ◽

Stephen T. Lawless ◽

Robert G. Kettrick

Keyword(s):

Noninvasive Ventilation ◽

Airway Pressure ◽

Pressure Support ◽

Positive Airway Pressure ◽

Pediatric Practice ◽

Bilevel Positive Airway Pressure

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Which tests may predict the need for noninvasive ventilation in children with neuromuscular disease?

Respiratory Medicine ◽

10.1016/j.rmed.2008.10.023 ◽

2009 ◽

Vol 103 (4) ◽

pp. 574-581 ◽

Cited By ~ 28

Author(s):

Brigitte Fauroux ◽

Guillaume Aubertin ◽

Annick Clément ◽

Frédéric Lofaso ◽

Monique Bonora

Keyword(s):

Noninvasive Ventilation ◽

Neuromuscular Disease

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Impact of Interface Type on Noninvasive Ventilation Efficacy in Patients With Neuromuscular Disease: A Randomized Cross-Over Trial

Archivos de Bronconeumología ◽

10.1016/j.arbres.2020.05.024 ◽

2020 ◽

Author(s):

Antoine Léotard ◽

Marius Lebret ◽

Najeh Daabek ◽

Hélène Prigent ◽

Marie Destors ◽

...

Keyword(s):

Noninvasive Ventilation ◽

Neuromuscular Disease ◽

Interface Type

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Performance of ICU ventilators during noninvasive ventilation with large leaks in a total face mask: a bench study

Jornal Brasileiro de Pneumologia ◽

10.1590/s1806-37132014000300013 ◽

2014 ◽

Vol 40 (3) ◽

pp. 294-303 ◽

Cited By ~ 6

Author(s):

Maria Aparecida Miyuki Nakamura ◽

Eduardo Leite Vieira Costa ◽

Carlos Roberto Ribeiro Carvalho ◽

Mauro Roberto Tucci

Keyword(s):

Noninvasive Ventilation ◽

Research Laboratory ◽

Pressure Support ◽

Face Mask ◽

University Research ◽

Positive End Expiratory Pressure ◽

Co2 Rebreathing ◽

Bench Study ◽

Internal Volume ◽

Co2 Elimination

Objective: Discomfort and noncompliance with noninvasive ventilation (NIV) interfaces are obstacles to NIV success. Total face masks (TFMs) are considered to be a very comfortable NIV interface. However, due to their large internal volume and consequent increased CO2 rebreathing, their orifices allow proximal leaks to enhance CO2 elimination. The ventilators used in the ICU might not adequately compensate for such leakage. In this study, we attempted to determine whether ICU ventilators in NIV mode are suitable for use with a leaky TFM. Methods: This was a bench study carried out in a university research laboratory. Eight ICU ventilators equipped with NIV mode and one NIV ventilator were connected to a TFM with major leaks. All were tested at two positive end-expiratory pressure (PEEP) levels and three pressure support levels. The variables analyzed were ventilation trigger, cycling off, total leak, and pressurization. Results: Of the eight ICU ventilators tested, four did not work (autotriggering or inappropriate turning off due to misdetection of disconnection); three worked with some problems (low PEEP or high cycling delay); and one worked properly. Conclusions: The majority of the ICU ventilators tested were not suitable for NIV with a leaky TFM.

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