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Scientific Articles

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

key information

source: Respiratory medicine

year: 2016

authors: Boussaïd G, Lofaso F, Santos DB, Vaugier I, Pottier S, Prigent H, Bahrami S, Orlikowski D

summary/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.

organization: Université de Versailles Saint Quentin en Yvelines, France; Hôpital Raymond Poincaré, France

DOI: 10.1016/j.rmed.2016.04.009

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