Titre : | Duchenne Muscular Dystrophy: Life Prolongation by Noninvasive Ventilatory Support. |
Revue : | American journal of physical medicine & rehabilitation, 93, 7 |
Auteurs : | Villanova M ; Brancalion B ; Mehta AD |
Type de document : | Article |
Année de publication : | 07/2014 |
Pages : | p. 595-9 |
Langues: | Anglais |
Mots-clés : | capacité vitale ; dystrophie musculaire de Duchenne ; étude observationnelle ; Europe (géographique) ; gaz carbonique ; Italie ; oxymétrie ; ventilation assistée ; ventilation non invasive |
Résumé : |
OBJECTIVE: American, Japanese, and Canadian centers have demonstrated that noninvasive intermittent positive pressure ventilatory support (NVS) can be used continuously and in the long-term by people with Duchenne muscular dystrophy as a definitive alternative to tracheostomy mechanical ventilation. The aim of this study was to report this for the first time in Europe.
DESIGN: In this study, more than 300 patients with Duchenne muscular dystrophy were followed. End-tidal carbon dioxide, oxyhemoglobin saturation, and vital capacity were measured at each visit. Of the 300 patients, 79 used NVS for 8 hrs or more per day and 20 of these became continuously dependent on NVS. RESULTS: A total of 20 patients have continuously depended on NVS for survival, for a total of 336 patient-years, up to 16 yrs in one case. Nocturnal NVS was begun for symptomatic hypoventilation when the vital capacity had decreased to a mean of 831 + 173 ml, and continuous dependence on NVS was necessary when the vital capacity had decreased below 297 + 113 ml. CONCLUSIONS: Noninvasive respiratory management can prolong survival without resorting to tracheotomy and without hospitalization. |
Pubmed / DOI : | DOI : 10.1097/PHM.0000000000000074 / Pubmed : 24743468 |
En ligne : | http://www.ncbi.nlm.nih.gov/pubmed/24743468 |