Impact of invasive ventilation on survival when non-invasive ventilation is ineffective in patients with Duchenne muscular dystrophy: A prospective cohort.

Abstract

BACKGROUND:

Many patients with DMD undergo tracheostomy. Tracheostomy is associated with certain complications, however its effect on prognosis is not known.

METHODS:

The relationship between type of mechanical ventilation and survival at 12 years was evaluated in a prospective cohort of patients with Duchenne muscular dystrophy followed in a French reference center for Neuromuscular Diseases. Cox proportional-hazards regressions were used to estimate the hazard ratios associated with risk of switching from non-invasive to invasive ventilation, and with risk of death.

RESULTS:

One hundred and fifty patients were included. Initial use of invasive ventilation was associated with an episode of acute respiratory failure (p < 0.0001) and with a severe clinical status (p < 0.05). Risk of death was associated with swallowing disorders (2.51, IC [1.12-5.66], p < 0.03) and cardiac failure (p < 0.05) but not with type of mechanical ventilation.

CONCLUSION:

Switching to invasive ventilation is appropriate when non-invasive ventilation is ineffective.

• Authors: Ghilas Boussaïd, Frédéric Lofaso, Dante Brasil Santos, Isabelle Vaugier, Sandra Pottier, Hélène Prigent, Stéphane Bahrami, David Orlikowski
• Journal: Respiratory medicine (Respir Med) Vol. 115 Pg. 26-32 (06 2016) ISSN: 1532-3064 [Electronic] England
• PMID: 27215500 (Publication Type: Journal Article, Observational Study)
• Copyright: Copyright © 2016 Elsevier Ltd. All rights reserved.

Topics

• Adolescent
• Adult
• Child
• Child, Preschool
• France (epidemiology)
• Heart Failure (complications, epidemiology, mortality)
• Humans
• Male
• Muscular Dystrophy, Duchenne (complications, epidemiology, mortality, therapy)
• Noninvasive Ventilation (adverse effects, methods)
• Prospective Studies
• Respiration, Artificial (adverse effects, mortality)
• Respiratory Insufficiency (complications, epidemiology, mortality)
• Survival Analysis
• Tracheostomy (adverse effects)
• Young Adult