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Noninvasive respiratory management and diaphragm and electrophrenic pacing in neuromuscular disease and spinal cord injury
Author(s) -
Bach John R.
Publication year - 2013
Publication title -
muscle and nerve
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.025
H-Index - 145
eISSN - 1097-4598
pISSN - 0148-639X
DOI - 10.1002/mus.23646
Subject(s) - medicine , diaphragm (acoustics) , spinal cord injury , neuromuscular disease , anesthesia , paralysis , ventilation (architecture) , respiratory system , neuromuscular junction , weakness , spinal cord , respiratory failure , mechanical ventilation , physical medicine and rehabilitation , surgery , disease , neuroscience , psychology , mechanical engineering , physics , psychiatry , acoustics , loudspeaker , engineering
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. Muscle Nerve, 2013