Particularités du sevrage de la ventilation mécanique chez les patients atteints de maladie neuromusculaire

Weaning from mechanical ventilation in neuromuscular diseases, in particular chronic ones, may be sometimes complicated. Non-invasive ventilation and cough assistance (especially using in- exsufflators) are crucial tools to manage patients in this situation. Their utilization will be discussed in this article with more details. When extubation becomes impossible, tracheotomy is usually not the best alternative. Thus, it should not be considered as the only option. When all non-invasive weaning means/techniques have been tested, limitation or discontinuation of active therapies in association with comfort and palliative care may be considered. We believe that intensive care units are appropriate places to handle such management.