Patients totalement dépendants de la ventilation non invasive (gestion, déplacements, quand envisager la trachéotomie ?)

Ventilation improvements have led to an increased number of ventilator-dependent neuromuscular patients. In order to ensure adequate ventilation efficiency and security while maintaining quality of life, the check-list is large. Two « life support » ventilators are mandatory, while different interfaces may be required for nighttime and daytime ventilation, in order to maintain communication. Airways clearance is a major goal. It requires physiotherapists, cough assistance devices and the participation of the relatives. The decision of tracheostomy needs to be individually evaluated. Permanent anticipation is necessary.