Source: Annual Congress 2008 - Progress and a new era for noninvasive mechanical ventilation
Disease area: Respiratory critical care



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Citations should be made in the following way:
M. Goncalves, J. R. Bach, I. Hamdani, J. C. Winck (Porto, Portugal; Newark, NJ, United States Of America). Extubation and noninvasive ventilatory management of unweanable patients with neuromuscular weakness. Eur Respir J 2008; 32: Suppl. 52, 363

Member's Comments

Emily Ballard - 07.10.2008 15:43
Resistance from ITU?
I would just like to congratulate you on a very interesting and important piece of work. I very much agree with what you suggest as a means to facilitate extubation in unweanable NMD patients. This is a technique which I have used personally and found to be very effective when specialist staff are available but it can be very labour intensive. Although we have 24 hour access to respiratory physiotherapy I have found non specialist staff often fail to treat to the same intensity perhaps due to a lack of experience in recognising the potential for success and the skills to persist with treatment. I therefore agree that families and carers should be encouraged to help facilitate acute treatments as this is a brilliant way to educate them in recognising the need to treat acutely (in a controlled environment) and in the patient's long term management. It is something that we practise in our specialist unit, however I wonder whether the introduction of "unqualified carers" into a general ITU would be welcomed? Did you come across any resistance? If so how was that managed? I must also comment on your fantastic frog breathing technique! I am currently perfecting mine with Barbara Webber. Best wishes Emily Ballard Specialist Neuromuscular Physiotherapist/ Transitional Care Coordinator for DMD The Lane Fox Unit, St Thomas'Hospital, London emily.ballard@gstt.nhs.uk

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