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dc.contributor.author
Bach, John R.
dc.contributor.author
Gonçalves, Miguel R.
dc.contributor.author
Hon, Alice
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Ishikawa, Yuka
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de Vito, Eduardo
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Prado, Francisco
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Dominguez, Maria Eugenia
dc.date.available
2017-10-11T20:35:34Z
dc.date.issued
2013-03
dc.identifier.citation
Bach, John R.; Gonçalves, Miguel R.; Hon, Alice; Ishikawa, Yuka; de Vito, Eduardo; et al.; Changing trends in the management of end-stage neuromuscular respiratory muscle failure: recommendations of an international consensus; Lippincott Williams; American Journal Of Physical Medicine & Rehabilitation; 92; 3; 3-2013; 267-277
dc.identifier.issn
0894-9115
dc.identifier.uri
http://hdl.handle.net/11336/26459
dc.description.abstract
OBJECTIVE: Respiratory management of patients with end-stage respiratory muscle failure of neuromuscular disease has evolved from no treatment and inevitable respiratory failure to the use of up to continuous noninvasive intermittent positive pressure ventilatory support (CNVS) to avert respiratory failure and to permit the extubation of "unweanable" patients without tracheostomy. An international panel experienced in CNVS was charged by the 69th Congress of the Mexican Society of Pulmonologists and Thoracic Surgeons to analyze changing respiratory management trends and to make recommendations. DESIGN: Neuromuscular disease respiratory consensuses and reviews were identified from PubMed. Individual respiratory interventions were identified; their importance was established by assessing the quality of evidence-based literature for each one and their patterns of use over time. The panel then determined the evidence-based strength for the efficacy of each intervention and made recommendations for achieving prolonged survival by CNVS. RESULTS: Fifty publications since 1993 were identified. Continuous positive airway pressure, oxygen therapy, bilevel positive airway pressure used at both low and high spans, "air stacking," manually assisted coughing, low pressure (<35 cm H2O) and high pressure (≥40 cm H2O) mechanically assisted coughing, noninvasive positive pressure ventilation part time (<23 hrs per day) and full time (>23 hrs per day; CNVS), extubation and decannulation of ventilator-dependent patients to CNVS, and oximetry feedback for noninvasive positive pressure ventilation and mechanically assisted coughing were identified. All noted interventions are being used with increasing frequency and were unanimously recommended to achieve prolonged survival by CNVS, with the exception of supplemental oxygen and continuous positive airway pressure, which are being used less and were not recommended for this population. CONCLUSIONS: CNVS and extubation of unweanable patients to CNVS are increasingly being used to prolong life while avoiding invasive interfaces.
dc.format
application/pdf
dc.language.iso
eng
dc.publisher
Lippincott Williams
dc.rights
info:eu-repo/semantics/openAccess
dc.rights.uri
https://creativecommons.org/licenses/by-nc-nd/2.5/ar/
dc.subject
Neuromuscular Disease
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Pulmonary
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Respiratory Muscle Failure
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Ventilation
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Sistema Respiratorio
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Medicina Clínica
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CIENCIAS MÉDICAS Y DE LA SALUD
dc.title
Changing trends in the management of end-stage neuromuscular respiratory muscle failure: recommendations of an international consensus
dc.type
info:eu-repo/semantics/article
dc.type
info:ar-repo/semantics/artículo
dc.type
info:eu-repo/semantics/publishedVersion
dc.date.updated
2015-08-14T18:16:42Z
dc.journal.volume
92
dc.journal.number
3
dc.journal.pagination
267-277
dc.journal.pais
Estados Unidos
dc.journal.ciudad
Filadelfia
dc.description.fil
Fil: Bach, John R.. University of Medicine and Dentistry of New Jersey; Estados Unidos
dc.description.fil
Fil: Gonçalves, Miguel R.. Universidad de Porto; Portugal
dc.description.fil
Fil: Hon, Alice. Universidad de Porto; Portugal
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Fil: Ishikawa, Yuka. National Organization Yakumo Hospital; Japón
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Fil: de Vito, Eduardo. Universidad de Buenos Aires. Facultad de Medicina. Instituto de Investigaciones Médicas; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina
dc.description.fil
Fil: Prado, Francisco. Universidad de Chile; Chile
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Fil: Dominguez, Maria Eugenia. Universidad Nacional Autónoma de México; México
dc.journal.title
American Journal Of Physical Medicine & Rehabilitation
dc.relation.alternativeid
info:eu-repo/semantics/altIdentifier/doi/http://dx.doi.org/10.1097/PHM.0b013e31826edcf1
dc.relation.alternativeid
info:eu-repo/semantics/altIdentifier/url/https://insights.ovid.com/pubmed?pmid=23051760
dc.relation.alternativeid
info:eu-repo/semantics/altIdentifier/url/http://journals.lww.com/ajpmr/pages/articleviewer.aspx?year=2013&issue=03000&article=00010&type=abstract
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