Noninvasive respiratory management and diaphragm and electrophrenic pacing in neuromuscular disease and spinal cord injury

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Abstract

The purpose of this monograph is to describe noninvasive management of respiratory muscle weakness/paralysis for patients with neuromuscular disease (NMD) and spinal cord injury (SCI). Noninvasive ventilation (NIV) assists and supports inspiratory muscles, whereas mechanically assisted coughing (MAC) simulates an effective cough. Long-term outcomes will be reviewed as well as the use of NIV, MAC, and electrophrenic pacing (EPP) and diaphragm pacing (DP) to facilitate extubation and decannulation. Although EPP and DP can facilitate decannulation and maintain alveolar ventilation for high-level SCI patients when they cannot use NIV because of lack of access to oral interfaces, there is no evidence that they have any place in the management of NMD.

Original languageEnglish (US)
Pages (from-to)297-305
Number of pages9
JournalMuscle and Nerve
Volume47
Issue number2
DOIs
Publication statusPublished - Feb 1 2013

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All Science Journal Classification (ASJC) codes

  • Physiology
  • Clinical Neurology
  • Cellular and Molecular Neuroscience
  • Physiology (medical)

Keywords

  • Assisted cough
  • Diaphragm pacing
  • Electrophrenic pacing
  • Glossopharyngeal breathing
  • Mechanical insufflation-exsufflation
  • Noninvasive mechanical ventilation
  • Respiratory therapy
  • Spinal cord injury
  • Tetraplegia

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