Preference of neuromuscular patients regarding equipment for daytime mouthpiece ventilation: A randomized crossover study.
Adolescent
Adult
Blood Gas Monitoring, Transcutaneous
/ methods
Carbon Dioxide
/ metabolism
Case-Control Studies
Cross-Over Studies
Dyspnea
/ diagnosis
Equipment Design
Female
Humans
Male
Neuromuscular Diseases
/ complications
Noninvasive Ventilation
/ instrumentation
Perception
Respiratory Insufficiency
/ therapy
Time Factors
Ventilators, Mechanical
/ statistics & numerical data
Young Adult
MPV
daytime ventilation
mouthpiece ventilation
neuromuscular disorder
noninvasive ventilation
Journal
The clinical respiratory journal
ISSN: 1752-699X
Titre abrégé: Clin Respir J
Pays: England
ID NLM: 101315570
Informations de publication
Date de publication:
Mar 2020
Mar 2020
Historique:
received:
24
04
2019
revised:
13
11
2019
accepted:
29
11
2019
pubmed:
5
12
2019
medline:
26
11
2020
entrez:
5
12
2019
Statut:
ppublish
Résumé
Patients with neuromuscular disorders (NMDs) are likely to develop respiratory failure which requires noninvasive ventilation (NIV). Ventilation via a mouthpiece (MPV) is an option to offer daytime NIV. To determine the preferred equipment for MPV by patients with NMDs. Two MPV equipment sets were compared in 20 patients with NMDs. Set 1, consisted of a non-dedicated ventilator for MPV (PB560, Covidien) with a plastic angled mouthpiece. Set 2, consisted of a dedicated MPV ventilator (Trilogy 100, Philips Respironics) without backup rate and kiss trigger combined with a silicone straw mouthpiece. The Borg dyspnea score, ventilator free time, transcutaneous oxygen saturation (SpO2) and carbon dioxide tension (TcCO Carbon dioxide tension measurements and total perception score were not different between the two MPV sets. Dyspnea score was lower with the non-dedicated versus dedicated equipment, 1 (0.5) versus 3 (1-6), P < 0.01. All patients with a ventilator free time lower than 6 hours preferred a set backup rate rather than a kiss trigger. Sixty five percent of patients preferred the commercial arm support and 55% preferred the plastic angled mouthpiece. Dedicated and non-dedicated MPV equipment are deemed effective and comfortable. Individualization of arm support and mouthpiece is advised to ensure success of MPV. A ventilator free time lower than 6 hours seems to be a useful indicator to a priori set a backup rate rather than a rate at zero associated to the kiss trigger.
Sections du résumé
BACKGROUND
BACKGROUND
Patients with neuromuscular disorders (NMDs) are likely to develop respiratory failure which requires noninvasive ventilation (NIV). Ventilation via a mouthpiece (MPV) is an option to offer daytime NIV.
OBJECTIVES
OBJECTIVE
To determine the preferred equipment for MPV by patients with NMDs.
METHODS
METHODS
Two MPV equipment sets were compared in 20 patients with NMDs. Set 1, consisted of a non-dedicated ventilator for MPV (PB560, Covidien) with a plastic angled mouthpiece. Set 2, consisted of a dedicated MPV ventilator (Trilogy 100, Philips Respironics) without backup rate and kiss trigger combined with a silicone straw mouthpiece. The Borg dyspnea score, ventilator free time, transcutaneous oxygen saturation (SpO2) and carbon dioxide tension (TcCO
RESULTS
RESULTS
Carbon dioxide tension measurements and total perception score were not different between the two MPV sets. Dyspnea score was lower with the non-dedicated versus dedicated equipment, 1 (0.5) versus 3 (1-6), P < 0.01. All patients with a ventilator free time lower than 6 hours preferred a set backup rate rather than a kiss trigger. Sixty five percent of patients preferred the commercial arm support and 55% preferred the plastic angled mouthpiece.
CONCLUSIONS
CONCLUSIONS
Dedicated and non-dedicated MPV equipment are deemed effective and comfortable. Individualization of arm support and mouthpiece is advised to ensure success of MPV. A ventilator free time lower than 6 hours seems to be a useful indicator to a priori set a backup rate rather than a rate at zero associated to the kiss trigger.
Substances chimiques
Carbon Dioxide
142M471B3J
Types de publication
Journal Article
Randomized Controlled Trial
Langues
eng
Sous-ensembles de citation
IM
Pagination
214-221Informations de copyright
© 2019 John Wiley & Sons Ltd.
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