Intermittent abdominal pressure ventilation management in neuromuscular diseases: a Delphi panel Consensus

Anna Annunziata, Paola Pierucci, Paolo Innocente Banfi, Annalisa Carlucci, Antonietta Coppola, Fabrizio Rao, Matteo Schisano, Francesca Simioli, Claudia Crimi, Antonio M. Esquinas, Zuhal Karakurt, Alessio Mattei, Antonella Marotta, John R. Bach, Giuseppe Fiorentino

Research output: Contribution to journalArticlepeer-review

2 Scopus citations

Abstract

Background: Intermittent abdominal pressure ventilator (IAPV) use started in the 1930s for ventilatory assistance with muscular dystrophy patients. Later, the device was perfected and expanded for other neuromuscular disorders (NMD). In recent years, the morbidity and mortality tracheotomies and trach tubes related renewed the interest around IAPV. However, there are no guidelines for its use. This study aimed to establish a consensus among physicians involved in its practice to provide IAPV suggestions for the treatment of patients with NMD. Method: A 3-step modified Delphi method was used to establish consensus. Fourteen respiratory physicians and one psychiatrist with strong experience in IAPV use and/or who published manuscripts on the topic participated in the panel. A systematic review of the literature was carried out according to the PRISMA to identify existing evidence on IAPV for patients with neuromuscular disorders. Results: In the first round, 34 statements were circulated. Panel members marked ‘agree’ or ‘disagree’ for each statement and provided comments. The agreement was reached after the second voting session for all 34 statements. Conclusions: Panel members agreed and IAPV indications, parameter settings (including procedure protocol), potential limitations, contraindications, complications, monitoring, and follow-up are described. This is the first expert consensus on IAPV.

Original languageEnglish (US)
Pages (from-to)517-525
Number of pages9
JournalExpert Review of Respiratory Medicine
Volume17
Issue number6
DOIs
StatePublished - 2023

All Science Journal Classification (ASJC) codes

  • Immunology and Allergy
  • Pulmonary and Respiratory Medicine
  • Public Health, Environmental and Occupational Health

Keywords

  • Delphi Panel
  • Noninvasive ventilation (NIV)
  • experts
  • intermittent abdominal pressure ventilator
  • neuromuscular disorders

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