کد مقاله | کد نشریه | سال انتشار | مقاله انگلیسی | نسخه تمام متن |
---|---|---|---|---|
5632428 | 1406536 | 2016 | 9 صفحه PDF | دانلود رایگان |
- Compliance with non-invasive ventilation is poor in patients with no subjective symptoms of hypercapnia.
- Cessation is more frequent in the cases of excessive leaks, ventilator dysfunction, or high body mass index.
- Cessation is less frequent for patients with a professional occupation.
This study evaluated compliance with non-invasive ventilation in patients with myotonic dystrophy type 1 and identified predictors of cessation at 5 years in a cohort of patients followed in a specialist center for Neuromuscular Diseases in France. Mechanical ventilation in these patients poses a very strong challenge to caregivers.Factors predicting relative compliance were identified using multivariate linear regressions. Cox proportional-hazards regression was used to estimate hazard ratios associated with risk of cessation. One hundred and twenty-eight patients were included. Compliance during the first year was higher when symptoms of respiratory failure were initially present (+25%, pâ<â0.003) and lower in the case of acute respiratory failure (â29%, pâ<â0.003). Long-term compliance was associated with symptoms of respiratory failure (+52%, pâ<â0.0001) and nocturnal arterial oxygen desaturation (+23%, pâ<â0.007). Cessation was more frequent in the cases of excessive leaks (HRâ=â7.81, IC [1.47-41.88], pâ<â0.01), ventilator dysfunction requiring emergency technical intervention (HRâ=â12.58, IC [1.22-129.69], pâ<â0.03) or high body mass index (pâ<â0.02). Cessation was less frequent for patients with a professional occupation or undergoing professional training (HRâ=â0.11, IC [0.02-0.77], pâ<â0.02). Compliance with non-invasive ventilation is poor in patients with no subjective symptoms of respiratory failure. It may be improved with appropriate education and follow-up.
Journal: Neuromuscular Disorders - Volume 26, Issue 10, October 2016, Pages 666-674