TY - JOUR T1 - Tracheostomy tubes are not needed for Duchenne muscular dystrophy JF - European Respiratory Journal JO - Eur Respir J SP - 179 LP - 180 DO - 10.1183/09031936.00156806 VL - 30 IS - 1 AU - J. R. Bach AU - C. Bianchi AU - J. Finder AU - T. Fragasso AU - M. R. Goncalves AU - Y. Ishikawa AU - A. K. Ramlall AU - D. McKim AU - E. Servera AU - A. Vianello AU - M. Villanova AU - J. C. Winck Y1 - 2007/07/01 UR - http://erj.ersjournals.com/content/30/1/179.abstract N2 - To the Editors: Respiratory failure is the main cause of death in patients with Duchenne muscular dystrophy (DMD). Some respiratory management paradigms recommend tracheostomy for ventilator-dependent DMD patients. Prolongation of survival by years and, in many cases, decades using continuous mechanical noninvasive ventilation (NIV) without tracheostomy has been reported 1. Toussaint et al. 2 reported their experience on the use of NIV along with assisted coughing to prolong life and avoid tracheostomy for patients with DMD. However, the commentary by Lofaso et al. 3 on this outstanding work was uninformed. The commentators failed to present the outcomes of continuous NIV from other centres 4–6 and they have, apparently, no experience in continuous long-term NIV. These authors seem to be unaware that more than 250 long-term (mostly 24-h dependent) NIV users whose main interface was a simple mouthpiece during the day and a mouthpiece with a plastic phalange during sleep have … ER -