Abstract
Introduction: Non-invasive ventilation (NIV) has been shown to improve the quality and quantity of life for DMD patients. However, very little is written about what triggers the commencement of NIV in these patients.
Aims: To determine the manner in which long term non-invasive ventilation is commenced in children with Duchenne Muscular Dystrophy (DMD).
Methods: A notes review of patients in the West of Scotland with Duchenne Muscular Dystrophy who have been commenced on non-invasive ventilation in the last 10 years.
Results: 19 patients were commenced on ventilation during the study period. The average age at starting ventilation was 17.5 years. 13 patients were started electively, based on an assessment of overnight ventilation, lung function and / or symptoms. All of the patients started electively were commenced on NIV by a respiratory consultant on a general respiratory ward, except one, who was commenced on NIV at home.
6 patients (32%) were started during an acute admission. Two of these were commenced NIV on the general respiratory ward by a respiratory consultant, the remainder were started on PICU. Four acute admissions were precipitated by pneumonia, one due to food aspiration, and one had an out of hospital cardiorespiratory arrest.
Conclusion: It is becoming increasingly common for patients with Duchenne muscular dystrophy to commence NIV electively. However, over the period study just under one-third started NIV during an acute admission.
There is the potential to increase the number of DMD patients commenced on NIV electively. However, the unpredictable nature of acute infections means that some patients will inevitably be commenced on NIV in a non-elective fashion.
- © 2014 ERS
