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Chapter 11 - Continuous Noninvasive Ventilatory Support and Mechanical Insufflation-Exsufflation for Long-Term Management, Extubation, and Decannulation of Patients with Ventilatory Pump Failure

Published online by Cambridge University Press:  26 May 2025

By
John R. Bach ,
Kevin Huang  and
Yuka Ishikawa
Edited by
Martin Groß ,
Eelco F. M. Wijdicks ,
Maxwell S. Damian  and
Oliver Summ
Martin Groß
Affiliation:
MEDIAN Clinic Bad Tennstedt
Eelco F. M. Wijdicks
Affiliation:
Mayo Clinic
Maxwell S. Damian
Affiliation:
Basildon University Hospitals
Oliver Summ
Affiliation:
Evangelisches Krankenhaus Oldenburg
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Summary

No one needs a tracheostomy tube only for being too weak to breathe, that is, for people with ventilatory pump failure. Noninvasive ventilatory support is safer, better tolerated and better maintains quality of life than does ventilatory support via tracheostomy. People at any age can become continuously dependent on (noninvasive) ventilatory support (CNVS) without ever going to a hospital or developing acute respiratory failure. People who depend on CNVS are more safely managed in their homes by trained care providers than in institutions or hospitals where supplemental oxygen therapy can result in acute respiratory failure. Here we discuss the management with respect to noninvasive ventilation or noninvasive ventilatory support for patients with ventilatory pump failure and discuss mechanical insufflation-exsufflation, intubation and extubation criteria for these patients.

Keywords

ventilatorypumpsupportnoninvasivemechanicalintubationextubationtracheostomy

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Type
Chapter
Information
Clinical Neurorespiratory Medicine , pp. 123 - 136
Publisher: Cambridge University Press
Print publication year: 2025

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References

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