Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Meta-Analysis
. 2014 Dec 13;2014(12):CD001941.
doi: 10.1002/14651858.CD001941.pub3.

Nocturnal mechanical ventilation for chronic hypoventilation in patients with neuromuscular and chest wall disorders

Djillali Annane  1 , David Orlikowski, Sylvie Chevret
Affiliations
Meta-Analysis

Nocturnal mechanical ventilation for chronic hypoventilation in patients with neuromuscular and chest wall disorders

Djillali Annane et al. Cochrane Database Syst Rev. .

Abstract

Background: Chronic alveolar hypoventilation is a common complication of many neuromuscular and chest wall disorders. Long-term nocturnal mechanical ventilation is commonly used to treat it. This is a 2014 update of a review first published in 2000 and previously updated in 2007.

Objectives: To examine the effects on mortality of nocturnal mechanical ventilation in people with neuromuscular or chest wall disorders. Subsidiary endpoints were to examine the effects of respiratory assistance on improvement of chronic hypoventilation, sleep quality, hospital admissions and quality of life.

Search methods: We searched the Cochrane Neuromuscular Disease Group Specialized Register, CENTRAL, MEDLINE and EMBASE on 10 June 2014. We contacted authors of identified trials and other experts in the field.

Selection criteria: We searched for quasi-randomised or randomised controlled trials of participants of all ages with neuromuscular or chest wall disorder-related stable chronic hypoventilation of all degrees of severity, receiving any type and any mode of long-term nocturnal mechanical ventilation. The primary outcome measure was one-year mortality and secondary outcomes were unplanned hospital admission, short-term and long-term reversal of hypoventilation-related clinical symptoms and daytime hypercapnia, improvement of lung function and sleep breathing disorders.

Data collection and analysis: We used standard Cochrane methodology to select studies, extract data and assess the risk of bias in included studies.

Main results: The 10 eligible trials included a total of 173 participants. Roughly half of the trials were at low risk of selection, attrition or reporting bias, and almost all were at high risk of performance and detection bias. Four trials reported mortality data in the long term. The pooled risk ratio (RR) of dying was 0.62 (95% confidence interval (CI) 0.42 to 0.91, P value = 0.01) in favour of nocturnal mechanical ventilation compared to spontaneous breathing. There was considerable and significant heterogeneity between the trials, possibly related to differences between the study populations. Information on unplanned hospitalisation was available from two studies. The corresponding pooled RR was 0.25 (95% CI 0.08 to 0.82, P value = 0.02) in favour of nocturnal mechanical ventilation. For most of the outcome measures there was no significant long-term difference between nocturnal mechanical ventilation and no ventilation. Most of the secondary outcomes were not assessed in the eligible trials. Three out of the 10 trials, accounting for 39 participants, two with a cross-over design and one with two parallel groups, compared volume- and pressure-cycled non-invasive mechanical ventilation in the short term. From the only trial (16 participants) on parallel groups, there was no difference in mortality (one death in each arm) between volume- and pressure-cycled mechanical ventilation. Data from the two cross-over trials suggested that compared with pressure-cycled ventilation, volume-cycled ventilation was associated with less sleep time spent with an arterial oxygen saturation below 90% (mean difference (MD) 6.83 minutes, 95% CI 4.68 to 8.98, P value = 0.00001) and a lower apnoea-hypopnoea (per sleep hour) index (MD -0.65, 95% CI -0.84 to -0.46, P value = 0.00001). We found no study that compared invasive and non-invasive mechanical ventilation or intermittent positive pressure versus negative pressure ventilation.

Authors' conclusions: Current evidence about the therapeutic benefit of mechanical ventilation is of very low quality, but is consistent, suggesting alleviation of the symptoms of chronic hypoventilation in the short term. In four small studies, survival was prolonged and unplanned hospitalisation was reduced, mainly in participants with motor neuron diseases. With the exception of motor neuron disease and Duchenne muscular dystrophy, for which the natural history supports the survival benefit of mechanical ventilation against no ventilation, further larger randomised trials should assess the long-term benefit of different types and modes of nocturnal mechanical ventilation on quality of life, morbidity and mortality, and its cost-benefit ratio in neuromuscular and chest wall diseases.

PubMed Disclaimer

Conflict of interest statement

D Annane: my group was the co‐ordinating centre of a publicly funded multicentre trial of non‐invasive ventilation in DMD that has been included in this review (Raphaël 1994), and we are co‐ordinating an ongoing, publicly funded, multicentre trial of non‐invasive ventilation in adults with myotonic dystrophy type 1.

S Chevret: none known.

D Orlikowski declares the following:

  1. grants from AFM for a randomised study of non‐invasive ventilation in myotonic dystrophy type 1 and from Phillips for a study of Average Volume Assured Pressure Support (AVAPS) in myotonic dystrophy type 1;

  2. fees from IP Santé à domicile;

  3. he has acted as a medical referee for Foyer ADEP Evry.

All the activities mentioned are in the field of care and research conducted in neuromuscular diseases and home ventilation.

Outside this work, he received funding from Covidien and from Genzyme to attend the AAN conference 2012.

Figures

1
1
Study flow diagram.
2
2
'Risk of bias' summary: review authors' judgements about each risk of bias item for each included study.
1.1
1.1. Analysis
Comparison 1 Nocturnal ventilation versus no ventilation, Outcome 1 Mortality at one year.
1.2
1.2. Analysis
Comparison 1 Nocturnal ventilation versus no ventilation, Outcome 2 Unplanned admission to hospital.
1.3
1.3. Analysis
Comparison 1 Nocturnal ventilation versus no ventilation, Outcome 3 No improvement of hypoventilation symptoms: long‐term.
1.4
1.4. Analysis
Comparison 1 Nocturnal ventilation versus no ventilation, Outcome 4 No improvement of daytime hypercapnia: short‐term.
1.5
1.5. Analysis
Comparison 1 Nocturnal ventilation versus no ventilation, Outcome 5 No improvement of daytime hypercapnia: long‐term.
1.6
1.6. Analysis
Comparison 1 Nocturnal ventilation versus no ventilation, Outcome 6 Daytime PaCO2: long‐term.
1.7
1.7. Analysis
Comparison 1 Nocturnal ventilation versus no ventilation, Outcome 7 Forced vital capacity: long‐term.
1.8
1.8. Analysis
Comparison 1 Nocturnal ventilation versus no ventilation, Outcome 8 Respiratory muscle strength: long‐term.
1.9
1.9. Analysis
Comparison 1 Nocturnal ventilation versus no ventilation, Outcome 9 Mean nocturnal SaO2: long‐term.
2.1
2.1. Analysis
Comparison 2 Volume‐cycled ventilation versus pressure‐cycled ventilation, Outcome 1 Mortality at one year (here 3‐month data).
2.2
2.2. Analysis
Comparison 2 Volume‐cycled ventilation versus pressure‐cycled ventilation, Outcome 2 No improvement of daytime hypercapnia: short‐term.
2.3
2.3. Analysis
Comparison 2 Volume‐cycled ventilation versus pressure‐cycled ventilation, Outcome 3 Daytime PaCO2: short‐term.
2.4
2.4. Analysis
Comparison 2 Volume‐cycled ventilation versus pressure‐cycled ventilation, Outcome 4 Forced vital capacity: short‐term.
2.5
2.5. Analysis
Comparison 2 Volume‐cycled ventilation versus pressure‐cycled ventilation, Outcome 5 Respiratory muscles strength.
2.6
2.6. Analysis
Comparison 2 Volume‐cycled ventilation versus pressure‐cycled ventilation, Outcome 6 Mean nocturnal SaO2: short‐term.
2.7
2.7. Analysis
Comparison 2 Volume‐cycled ventilation versus pressure‐cycled ventilation, Outcome 7 Time spent with nocturnal SaO2 below 90%: short‐term.
2.8
2.8. Analysis
Comparison 2 Volume‐cycled ventilation versus pressure‐cycled ventilation, Outcome 8 Apnoea‐hypopnoea index (/hour): short‐term.
See this image and copyright information in PMC

Update of

References

References to studies included in this review

Bourke 2006 {published data only}
    1. Bourke SC, Tomlinson M, Williams TL, Bullock RE, Shaw PJ, Gibson GJ. Effects of non‐invasive ventilation on survival and quality of life in patients with amyotrophic lateral sclerosis: a randomised controlled trial. Lancet Neurology 2006;5(2):140‐7. [PUBMED: 16426990] - PubMed
Jackson 2001 {published data only}
    1. Jackson CE, Rosenfeld J, Moore DH, Bryan WW, Barohn RJ, Wrench M, et al. A preliminary evaluation of a prospective study of pulmonary function studies and symptoms of hypoventilation in ALS/MND patients. Journal of the Neurological Sciences 2001;191(1‐2):75‐8. [PUBMED: 11676995] - PubMed
Jaye 2009 {published data only}
    1. Jaye J, Chatwin M, Dayer M, Morrell MJ, Simonds AK. Autotitrating versus standard noninvasive ventilation: a randomised crossover trial. European Respiratory Journal 2009;33(3):566‐71. [PUBMED: 19251798 ] - PubMed
Laserna 2003 {published data only}
    1. Laserna E, Barrot E, Beiztegui A, Quintana E, Hernandez A, Castillo J. Non‐invasive ventilation in kyphoscoliosis. A comparison of a volumetric ventilator and a BiPAP support pressure device [Ventilacion no invasiva en cifoescoliosis. Estudio comparativo entre respirador volumetrico y soporte de presion (BiPAP)]. Archivos de Bronconeumologia 2003;39(1):13‐8. [PUBMED: 12550014] - PubMed
Pinto 1995 {published data only}
    1. Pinto AC, Evangelista T, Carvalho M, Alves MA, Sales Luis ML. Respiratory assistance with a non‐invasive ventilator (Bipap) in MND/ALS patients: survival rates in a controlled trial. Journal of the Neurological Sciences 1995;129(Suppl):19‐26. [PUBMED: 7595610] - PubMed
Raphaël 1994 {published and unpublished data}
    1. Raphaël JC, Chevret S, Chastang C, Bouvet F, and the French Multicenter Cooperative Group on Home Mechanical Ventilation Assistance in Duchenne de Boulogne Muscular Dystrophy. Randomised trial of preventive nasal ventilation in Duchenne muscular dystrophy. Lancet 1994;343(8913):1600‐4. [PUBMED: 7911921 ] - PubMed
Struik 2011 {published data only}
    1. Struik FM, Duiverman ML, Meijer PM, Nieuwenhuis JA, Kerstjens HA, Wijkstra PJ. Volume‐targeted versus pressure‐targeted noninvasive ventilation in patients with chest‐wall deformity: a pilot study. Respiratory Care 2011;56(10):1522–5. [PUBMED: 21513604] - PubMed
Tuggey 2005 {published data only}
    1. Tuggey JM, Elliott MW. Randomised crossover study of pressure and volume non‐invasive ventilation in chest wall deformity. Thorax 2005;60(10):859–64. [PUBMED: 12550014] - PMC - PubMed
Ward 2005 {published data only}
    1. Ward S, Chatwin M, Heather S, Simonds AK. Randomised controlled trial of non‐invasive ventilation (NIV) for nocturnal hypoventilation in neuromuscular and chest wall disease patients with daytime normocapnia. Thorax 2005;60(12):1019‐24. [PUBMED: 16299118] - PMC - PubMed
Willson 2004 {published data only}
    1. Willson GN, Piper AJ, Norman M, Chaseling WG, Milross MA, Collins ER, et al. Nasal versus full face mask for noninvasive ventilation in chronic respiratory failure. European Respiratory Journal 2004;23(4):605‐9. [PUBMED: 15083762] - PubMed

References to studies excluded from this review

Aboussouan 1997 {published data only}
    1. Aboussouan LS, Khan SU, Meeker DP, Stelmach K, Mitsumoto H. Effect of noninvasive positive‐pressure ventilation on survival in amyotrophic lateral sclerosis. Annals of Internal Medicine 1997;127(6):450‐3. - PubMed
Ambrosino 1997 {published data only}
    1. Ambrosino N, Vitacca M, Polese G, Pagani M, Foglio K, Rossi A. Short term effects of nasal proportional assist ventilation in patients with chronic hypercapnic respiratory insufficiency. European Respiratory Journal 1997;10(12):2829‐34. - PubMed
Bach 1998 {published data only}
    1. Bach JR, Rajaraman R, Ballanger F, Tzeng AC, Ishikawa Y, Kulessa R, et al. Neuromuscular ventilatory insufficiency: effect of home mechanical ventilator use versus oxygen therapy on pneumonia and hospitalization rates. American Journal of Physical Medicine and Rehabilitation 1998;77(1):8‐19. - PubMed
Celikel 1998 {published data only}
    1. Celikel T, Sungur M, Ceyhan B, Karakurt S. Comparison of noninvasive positive pressure ventilation with standard medical therapy in hypercapnic acute respiratory failure. Chest 1998;114:1636‐42. - PubMed
Chatwin 2008 {published data only}
    1. Chatwin M, Nickol AH, Morrell MJ, Polkey MI, Simonds AK. Randomised trial of inpatient versus outpatient initiation of home mechanical ventilation in patients with nocturnal hypoventilation. Respiratory Medicine 2008;102(11):1528‐35. - PubMed
Crescimanno 2011 {published data only}
    1. Crescimanno G, Maronne O, Vianello A. Efficacy and comfort of volume‐guaranteed pressure support inpatients with chronic ventilatory failure of neuromuscular origin. Respirology 2011;16(4):672–9. - PubMed
Elliott 1994 {published data only}
    1. Elliott MW, Aquilina R, Green M, Moxham J, Simonds AK. A comparison of different modes of noninvasive ventilatory support: effects on ventilation and inspiratory muscle effort. Anaesthesia 1994;49(4):279‐83. - PubMed
Ellis 1987 {published data only}
    1. Ellis ER, Bye PT, Bruderer JW, Sullivan CE. Treatment of respiratory failure during sleep in patients with neuromuscular disease: positive pressure ventilation through a nose mask. American Review Respiratory Disease 1987;135(1):148‐52. - PubMed
Fanfulla 2005 {published data only}
    1. Fanfulla F, Delmastro M, Berardinelli A, Lupo ND, Nava S. Effects of different ventilator settings on sleep and inspiratory effort in patients with neuromuscular disease. American Journal of Respiratory and Critical Care Medicine 2005;172(5):619‐24. - PubMed
Hart 2002 {published data only}
    1. Hart N, Hunt A, Polkey MI, Fauroux B, Lofaso F, Simonds AK. Comparison of proportional assist ventilation and pressure support ventilation in chronic respiratory failure due to neuromuscular and chest wall deformity. Thorax 2002;57:979–81. - PMC - PubMed
Highcock 2002 {published data only}
    1. Highcock MP, Morrish E, Jamieson S, Shneerson JM, Smith IE. An overnight comparison of two ventilators used in the treatment of chronic respiratory failure. European Respiratory Journal 2002;20:942–5. - PubMed
Masa 1997 {published data only}
    1. Masa JF, Celli BR, Riesco JA, Sanchez de Cos J, Disdier C, Sojo A. Noninvasive positive pressure ventilation and not oxygen may prevent overt ventilatory failure in patients with chest wall diseases. Chest 1997;112(1):207‐13. - PubMed
Meecham Jones 1993 {published data only}
    1. Meecham Jones DJ, Wedzicha JA. Comparison of pressure and volume preset nasal ventilator systems in stable chronic respiratory failure. European Respiratory Journal 1993;6(7):1060‐4. - PubMed
Orlikowski 2009 {published data only}
    1. Orlikowski D, Mroue G, Prigent H, Moulin C, Bohic M, Ruquet M, et al. Automatic air‐leak compensation in neuromuscular patients: a feasibility study. Respiratory Medicine 2009;103(2):173‐9. - PubMed
Padman 1998 {published data only}
    1. Padman R, Lawless ST, Kettrick RG. Noninvasive ventilation via bilevel positive airway pressure support in pediatric practice. Critical Care Medicine 1998;26(1):169‐73. - PubMed
Restrick 1993 {published data only}
    1. Restrick LJ, Fox NC, Braid G, Ward EM, Paul EA, Wedzicha JA. Comparison of nasal pressure support ventilation with nasal intermittent positive pressure ventilation in patients with nocturnal hypoventilation. European Respiratory Journal 1993;6(3):364‐70. - PubMed

Additional references

Annane 1999
    1. Annane D, Quera‐Salva MA, Lofaso F, Vercken JB, Lesieur O, Fromageot C, et al. Mechanisms underlying effects of nocturnal ventilation on daytime blood gases in neuromuscular diseases. European Respiratory Journal 1999;13(1):157‐62. - PubMed
Arras 1995
    1. Arras JD. Bringing the Hospital Home: Ethical and Social Implications of High‐tech Home Care. Baltimore: The Johns Hopkins University Press, 1995. [080184990xISBN 080184990x]
Bach 1987
    1. Bach JR, Alba A, Mosher R, Delaubier A. Intermittent positive pressure ventilation via nasal access in the management of respiratory insufficiency. Chest 1987;92(1):169‐70. - PubMed
Bach 2011
    1. Bach JR, Martinez D. Duchenne muscular dystrophy: continuous noninvasive ventilatory support prolongs survival. Respiratory Care 2011;56(6):744–50. - PubMed
Bach 2013
    1. Bach JR, Gonçalves MR, Hon A, Ishikawa Y, Vito EL, Prado F, et al. Changing trends in the management of end‐stage neuromuscular respiratory muscle failure: recommendations of an international consensus. American Journal of Physical Medicine & Rehabilitation 2013;92(3):267‐77. [PUBMED: 23051760] - PubMed
Barbé 1996
    1. Barbé F, Quera‐Salva MA, Lattre J, Gajdos P, Agusti AGN. Long term effects of nasal intermittent positive‐pressure ventilation on pulmonary function and sleep architecture in patients with neuromuscular diseases. Chest 1996;110(5):1179‐83. - PubMed
Carroll 1988
    1. Carroll N, Branthwaite MA. Control of nocturnal hypoventilation by nasal intermittent positive pressure ventilation. Thorax 1988;43(5):349‐53. - PMC - PubMed
Chailleux 1996
    1. Chailleux E, Fauroux B, Binet F, Dautzenberg B, Polu JM for the Observatory Group of ANTADIR. Predictors of survival in patients receiving domiciliary oxygen therapy or mechanical ventilation. Chest 1996;109(3):741‐9. - PubMed
Chatwin 2010
    1. Chatwin M, Heather S, Hanak A, Polkey MI, Simonds AK. Analysis of home support and ventilator malfunction in 1,211 ventilator‐dependent patients. European Respiratory Journal 2010;35(2):310‐6. - PubMed
Claman 1996
    1. Claman DM, Piper A, Sanders MH, Stiller RA, Votteri BA. Nocturnal non‐invasive positive pressure ventilatory assistance. Chest 1996;110(6):1581‐8. - PubMed
Eagle 2002
    1. Eagle M, Baudouin SV, Chandler C, Giddings DR, Bullock R, Bushby K. Survival in Duchenne muscular dystrophy: improvements in life expectancy since 1967 and the impact of home nocturnal ventilation. Neuromuscular Disorders 2002;12(10):926‐9. - PubMed
GRADEpro 2008 [Computer program]
    1. Jan Brozek, Andrew Oxman, Holger Schünemann. GRADEpro. Version 3.2 for Windows. Jan Brozek, Andrew Oxman, Holger Schünemann, 2008.
Gregoretti 2013
    1. Gregoretti C, Ottonello G, Chiarini Testa MB, Mastella C, Ravà L, Bignamini E, et al. Survival of patients with spinal muscular atrophy type 1. Pediatrics 2013;131(5):e1509‐14. - PubMed
Heckmatt 1990
    1. Heckmatt JZ, Loh L, Dubowitz V. Night time nasal ventilation in neuromuscular disease. Lancet 1990;335(8689):579‐82. - PubMed
Higgins 2011
    1. Higgins JPT, Green S (editors). Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0 [updated March 2011]. The Cochrane Collaboration, 2011. Available from www.cochrane‐handbook.org.
Hoeppner 1984
    1. Hoeppner VH, Cockcroft DW, Dosman JA, Cotton DJ. Nighttime ventilation improves respiratory failure in secondary kyphoscoliosis. American Review of Respiratory Disease 1984;129(2):240‐3. - PubMed
King 2012
    1. King AC. Long‐term home mechanical ventilation in the United States. Respiratory Care 2012;57(6):921‐30. [PUBMED: 22663967] - PubMed
Lewarski 2007
    1. Lewarski JS, Gay PC. Current issues in home mechanical ventilation. Chest 2007;132(2):671–6. [PUBMED: 17699139] - PubMed
Lloyd‐Owen 2005
    1. Lloyd‐Owen SJ, Donaldson GC, Ambrosino N, Escarabill J, Farre R, Fauroux B, et al. Patterns of home mechanical ventilation use in Europe: results of the European Survey. European Respiratory Journal 2005;25(6):1025‐31. - PubMed
Loh 1979
    1. Loh L, Hughes JM, Davis J. Gas exchange problems in bilateral diaphragm paralysis. Bulletin Européen de Physiopathologie Respiratoire 1979;15(Suppl):137‐41. - PubMed
Make 1998
    1. Make BJ, Hill NS, Goldberg AI, Bach JR, Criner GJ, Dunne PE, et al. Mechanical ventilation beyond the intensive care unit: report of a consensus conference of the American College of Chest Physicians. Chest 1998;113(5 Suppl):289S‐344S. - PubMed
McDougall 2013
    1. McDougall CM, Adderley RJ, Wensley DF, Seear MD. Long‐term ventilation in children: longitudinal trends and outcomes. Archives of Disease in Childhood 2013;98(9):660‐5. - PubMed
McKim 2013
    1. McKim DA, Griller N, LeBlanc C, Woolnough A, King J. Twenty‐four hour noninvasive ventilation in Duchenne muscular dystrophy: a safe alternative to tracheostomy. Canadian Respiratory Journal 2013;20(1):e5‐e9. - PMC - PubMed
Milligan 1991
    1. Milligan S. American Association for Respiratory Care and Gallup estimate numbers and costs of caring for chronic ventilator patients. American Association for Respiratory Care Times 1991;15:30‐6.
Newsom‐Davis 1980
    1. Newsom‐Davis J. The respiratory system in muscular dystrophy. British Medical Bulletin 1980;36(2):135‐8. - PubMed
Orlikowski 2005
    1. Orlikowski D, Prigent H, Gonzalez J, Sharshar T, Raphaël JC. Long term domiciliary mechanical ventilation in patients with neuromuscular diseases (indications, establishment and follow up) [Ventilation mécanique à domicile et au long cours des patients neuromusculaires (indications, mise en place et surveillance)]. Revue des Maladies Respiratoires 2005;22(6 Pt 1):1021‐30. - PubMed
Passamano 2012
    1. Passamano L, Taglia A, Palladino A, Viggiano E, D'Ambrosio P, Scutifero M, et al. Improvement of survival in Duchenne Muscular Dystrophy: retrospective analysis of 835 patients. Acta Myologica 2012;31(2):121‐5. [PUBMED: 23097603] - PMC - PubMed
Raphaël 1987
    1. Raphaël JC, Gajdos P, Lattre J. Chronic respiratory insufficiency related to neuromuscular diseases, therapeutic perspectives [Handicape respiratoire chronique d’origine neuromusculaire: physiopathologie, perspectives thérapeutiques]. Fonction diaphragmatique ‐ Travail respiratoire. Monographie de la Société de Réanimation de Langue Française. Paris: Expansion Scientifique Française, 1987:203‐28.
Raphaël 1999
    1. Raphaël JC, Chevret S, Annane D. Is early noninvasive mechanical ventilation of first choice in stable restrictive patients with chronic respiratory failure?. Monaldi Archives of Chest Disease 1999;54(1):90‐7. - PubMed
RevMan 2014 [Computer program]
    1. The Nordic Cochrane Centre, The Cochrane Collaboration. Review Manager (RevMan). Version 5.3. Copenhagen: The Nordic Cochrane Centre, The Cochrane Collaboration, 2014.
Simonds 2003
    1. Simonds AK. Home ventilation. European Respiratory Journal. Supplement 2003;22(Suppl 47):38S‐46S. - PubMed
Skatrud 1980
    1. Skatrud J, Iber C, McHugh W, Rasmussen H, Nichols D. Determinants of hypoventilation during wakefulness and sleep in diaphragmatic paralysis. American Review of Respiratory Disease 1980;121(3):587‐93. - PubMed
Smith 1987
    1. Smith PE, Calverley PM, Edwards RH, Evans GA, Campbell EJ. Practical problems in the respiratory care of patients with muscular dystrophy. New England Journal of Medicine 1987;316(19):1197‐205. - PubMed
Toussaint 2006
    1. Toussaint M, Steens M, Wasteels G, Soudon P. Diurnal ventilation via mouthpiece: survival in end‐stage Duchenne patients. European Respiratory Journal 2006;28(3):549–55. - PubMed
Wollinsky 2012
    1. Wollinsky KH, Kutter B, Geiger PM. Long‐term ventilation of patients with Duchenne muscular dystrophy:experiences at the Neuromuscular Centre Ulm. Acta Myologica 2012;31(3):170‐8. - PMC - PubMed

References to other published versions of this review

Annane 2000
    1. Annane D, Chevrolet JC, Chevret S, Raphaël JC. Nocturnal mechanical ventilation for chronic hypoventilation in patients with neuromuscular and chest wall disorders. Cochrane Database of Systematic Reviews 2000, Issue 1. [DOI: 10.1002/14651858.CD001941] - DOI - PubMed
Annane 2007
    1. Annane D, Orlikowski D, Chevret S, Chevrolet JC, Raphaël JC. Nocturnal mechanical ventilation for chronic hypoventilation in patients with neuromuscular and chest wall disorders. Cochrane Database of Systematic Reviews 2007, Issue 4. [DOI: 10.1002/14651858.CD001941.pub2] - DOI - PubMed

Publication types

MeSH terms

LinkOut - more resources