RT Journal Article
SR Electronic
T1 Beneficial effects of non-invasive positive pressure ventilation before vertebral arthrodesis in patients with Duchenne muscular dystrophy
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP P2964
VO 44
IS Suppl 58
A1 Jessica Taytard
A1 Raphaël Vialle
A1 Michelle Mayer
A1 Laurent Servais
A1 Harriet Corvol
A1 Annick Clement
A1 Guillaume Aubertin
YR 2014
UL http://erj.ersjournals.com/content/44/Suppl_58/P2964.abstract
AB Introduction: Vertebral surgery for Duchenne muscular dystrophy (DMD) patients remains a challenge. The objective of this study was to analyse the postoperative respiratory outcome, according to the use of preoperative non-invasive positive pressure ventilation (NPPV).Patients and Methods: Retrospective study including 13 DMD patients who benefited from a vertebral arthrodesis in a tertiary referral hospital between January 2010 and June 2013. Median age was 13 years old (11.6-16.2) at time of surgery. The surgery was a posterior arthrodesis without thoracotomy. We compared 2 groups of patients with or without preoperative NPPV: NPPV group (8 patients) and non NNPV group (5 patients). We studied preoperative and postoperative pulmonary function test and respiratory muscle strength in these 2 groups. We analysed two main parameters: durations of postoperative invasive ventilation (IV) and hospitalisation in intensive care unit (ICU).Results: In the NPPV and non NPPV group, median forced vital capacity was respectively of 37% (29-57%) and 50% (59-42%). Total lung capacity was respectively of 61 % (71-47%) and 68 % (80-49%). There was no statistical difference as for the two main parameters studied. But we showed in NPPV patients a tendency towards shorter postoperative IV (1 vs 2 days) and ICU stay (2 vs 3 days). One patient, who did not benefit from preoperative NPPV, had a postoperative pulmonary atelectasis.Conclusion: For DMD patients with severe scoliosis, preoperative NPPV tends to reduce both postoperative IV and ICU stay durations after the vertebral arthrodesis, even for patients with more severely altered pulmonary functions.