1
|
Retraction: Ferrari Aggradi, CR, Falcier, E, Lizio, A, et al. Assessment of respiratory function and need for non-invasive ventilation in a cohort of patients with myotonic dystrophy type 1 followed at one single expert centre. The Clinical Respiratory Journal. 2022; 1- 13. (https://doi.org/10.1111/crj.13516). THE CLINICAL RESPIRATORY JOURNAL 2023; 17:339. [PMID: 35760069 PMCID: PMC10113278 DOI: 10.1111/crj.13516] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/04/2021] [Revised: 05/15/2022] [Accepted: 05/25/2022] [Indexed: 12/01/2022]
Abstract
The above article, published online on 27 June 2022 in Wiley Online Library (wileyonlinelibrary.com), has been retracted by agreement between the authors, the journal Editors in Chief, Professor Paul Jones and Professor Yuanlin Song and John Wiley and Sons Ltd. The retraction has been agreed due to an error with the publisher and author which caused a duplicate of the article to be published on 27 June 2022. The correct version of the article is to be found at: Carola R. Ferrari Aggradi, Elisa Falcier, Andrea Lizio, Alice Pirola, Jacopo Casiraghi, Alice Zanolini, Elena Carraro, Luca Mauro, Fabrizio Rao, Elisabetta Roma, Antonino Iannello, Elisa De Mattia, Andrea Barp, Sara Lupone, Valentina Gatti, Cristina Italiano, Valeria A. Sansone, "Assessment of Respiratory Function and Need for Noninvasive Ventilation in a Cohort of Patients with Myotonic Dystrophy Type 1 Followed at One Single Expert Center", Canadian Respiratory Journal, vol. 2022, Article ID 2321909, 11 pages, 2022. https://doi.org/10.1155/2022/2321909.
Collapse
|
2
|
Delbarre B, Rapin A, Boyer FC, Thierry A, Perotin JM, Dury S, Dumazet A, Hagenburg J, Perdu D, Deslée G, Launois C. Dyspnea assessment in myotonic dystrophy type 1. Neuromuscul Disord 2023; 33:187-195. [PMID: 36669462 DOI: 10.1016/j.nmd.2022.12.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Revised: 07/29/2022] [Accepted: 12/30/2022] [Indexed: 01/01/2023]
Abstract
In myotonic mystrophy type 1 (DM1), combining respiratory symptom screening and respiratory function testing, is crucial to identify the appropriate time for ventilatory support initiation. Dyspnea has been little investigated in DM1. To provide a multidimensional description of dyspnea, questionnaires assessing dyspnea were administered to 34 consecutive adult patients with DM1 (median (25th-75th centile) age of 36 (28-49), Vital Capacity (VC) of 74 (64-87)% of predicted value). Dyspnea scores were low whatever the questionnaire used: Multidimensional Dyspnea Profile score of 2(0-4.7)/50 for dyspnea sensory descriptor and of 0 (0-4.7)/60 for the emotional descriptor, Visual Analogue Scale score of 0 (0-0)/10 in sitting and supine position and Borg score after six-minute walk test (6MWT) of 2.2 (1.8-4.2)/10. Eleven patients (32%) reported disabling dyspnea in daily living (modified Medical Research Council (mMRC) score ≥ 2). In comparison with patients with mMRC score < 2, patients with mMRC score ≥ 2 had a more severe motor handicap (Muscular Impairment Rating score of 4.0 (4.0-4.0) vs 3.0 (2.0-3.5), p<0.01), a lower 6MWT distance (373 (260-424) vs 436 (346-499)m, p = 0.03) and a lower VC (64 (48-74)% vs 75 (69-89)%, p = 0.02). These data suggest that the mMRC scale might be an easy-to-use and useful tool to assess dyspnea in daily living in DM1 patients. However, the interest of integrating the mMRC dyspnea scale in clinical practice to guide therapeutic management of DM1 patients remains to be assessed in further studies.
Collapse
Affiliation(s)
- B Delbarre
- Service des Maladies Respiratoires, CHU Reims, France
| | - A Rapin
- Service de Médecine Physique et Réadaptation, CHU Reims, France; UR3797, VieFra, Université de Reims Champagne Ardenne, Reims, France
| | - F C Boyer
- Service de Médecine Physique et Réadaptation, CHU Reims, France; UR3797, VieFra, Université de Reims Champagne Ardenne, Reims, France
| | - A Thierry
- Département de Méthodologie, CHU Reims, France; UR3797, VieFra, Université de Reims Champagne Ardenne, Reims, France
| | - J M Perotin
- Service des Maladies Respiratoires, CHU Reims, France; INSERM UMRS-1250, Université Reims Champagne Ardenne, Reims, France
| | - S Dury
- Service des Maladies Respiratoires, CHU Reims, France
| | - A Dumazet
- Service des Maladies Respiratoires, CHU Reims, France
| | - J Hagenburg
- Service des Maladies Respiratoires, CHU Reims, France
| | - D Perdu
- Service des Maladies Respiratoires, CHU Reims, France
| | - G Deslée
- Service des Maladies Respiratoires, CHU Reims, France; INSERM UMRS-1250, Université Reims Champagne Ardenne, Reims, France
| | - C Launois
- Service des Maladies Respiratoires, CHU Reims, France; INSERM UMRS-1250, Université Reims Champagne Ardenne, Reims, France.
| |
Collapse
|
3
|
Development of prediction models based on respiratory assessments to determine the need for non-invasive ventilation in patients with myotonic dystrophy type 1. Neurol Sci 2023; 44:2149-2157. [PMID: 36694070 DOI: 10.1007/s10072-023-06631-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Accepted: 01/17/2023] [Indexed: 01/26/2023]
Abstract
INTRODUCTION Myotonic dystrophy type 1 is a slowly progressive, multisystem, autosomal dominant disorder, in which the impairments of respiratory systems represent one of the main causes of death. OBJECTIVE The aim of our study is to develop prediction models to identify the most appropriate test(s) providing indication for NIV. METHODS DM1 patients attending the NEMO Clinical Center (Milan) between January 2008 and July 2020, who had been subjected to a complete battery of respiratory tests, were retrospectively recruited. Demographic, clinical, and anthropometric characteristics were collected, as well as arterial blood gas (ABG) analysis, spirometry, respiratory muscle strength, cough efficacy, and nocturnal oximetry as respiratory assessments. Patients were stratified in those requiring NIV and those with normal respiratory function. RESULTS Out of 151 DM1 patients (median age: 44 years [35.00-53.00]; male/female ratio: 0.80 (67/84)), 76 had an indication for NIV initiation (50.33%). ABG, spirometry, and nocturnal oximetry prediction models resulted in an excellent discriminatory ability in distinguishing patients who needed NIV from those who did not (AUC of 0.818, 0.808, and 0.935, respectively). An easy-to-use calculator was developed to automatically determine a score of NIV necessity based on the prediction equations generated from each aforementioned prediction model. CONCLUSIONS The proposed prediction models may help to identify which patients are at a higher risk of requiring ventilator support and therefore help in defining individual management plans and criteria for specific interventions early in the disease course.
Collapse
|
4
|
Assessment of Respiratory Function and Need for Noninvasive Ventilation in a Cohort of Patients with Myotonic Dystrophy Type 1 Followed at One Single Expert Center. Can Respir J 2022; 2022:2321909. [PMID: 35762008 PMCID: PMC9233572 DOI: 10.1155/2022/2321909] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Revised: 04/09/2022] [Accepted: 04/18/2022] [Indexed: 11/28/2022] Open
Abstract
Introduction Respiratory insufficiency is one of the main causes of death in myotonic dystrophy type 1 (DM1). Although there is general consensus that these patients have a restrictive ventilatory pattern, hypoventilation, chronic hypercapnia, and sleep disturbances, the prevalence of respiratory disease and indication for the effects of noninvasive ventilation (NIV) need to be further explored. Objectives To describe respiratory function and need for NIV at baseline and over time in a cohort of adult patients with DM1. Methods A total of 151 adult patients with DM1 were subjected to arterial blood gas analysis, sitting and supine forced vital capacity (FVC), peak cough expiratory flow (PCEF), nocturnal oximetry, and maximal inspiratory pressure and expiratory pressure (MIP/PEP). Results On first assessment, 84 of 151 had normal respiratory function (median age: 38 years, median BMI: 23.9, and median disease duration: 11 years); 67 received an indication to use NIV (median age: 49 years, median BMI: 25,8, and median disease duration: 14 years). After a median time of 3.85 years, 43 patients were lost to follow-up; 9 of 84 required NIV; only 17 of 67 with the new NIV prescription were adherent. Conclusions We provide additional data on the natural history of respiratory function decline and treatment adherence in a relatively large cohort of well-characterized patients with DM1. A high proportion (28%) was lost to follow-up. A minority (11%) required NIV, and only 25% were treatment adherent, irrespective of specific demographics and respiratory features. Our results also confirm previous findings, showing that age, disease duration, and higher BMIs are predisposing factors for respiratory impairment.
Collapse
|
5
|
Rautemaa V, Roberts ME, Bentley A, Felton TW. The role of noninvasive ventilation in the management of type II respiratory failure in patients with myotonic dystrophy. ERJ Open Res 2021; 7:00192-2020. [PMID: 34322542 PMCID: PMC8311128 DOI: 10.1183/23120541.00192-2020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Accepted: 05/16/2021] [Indexed: 11/07/2022] Open
Abstract
Type 1 myotonic dystrophy (DM1) causes sleep disordered breathing and respiratory failure due to a combination of obstructive sleep apnoea, reduced central drive and respiratory muscle weakness. Noninvasive ventilation (NIV) is commonly used for treating respiratory failure in neuromuscular disease; however, there have been few studies assessing the role of NIV in DM1. The aim of this retrospective service evaluation was to investigate the impact of NIV adherence on hypercapnia and symptoms of hypoventilation in patients with DM1. Data on capillary carbon dioxide tension (PCO2), lung function, adherence to NIV and symptoms of hypoventilation were obtained from the records of 40 patients with DM1. Mean capillary PCO2 significantly reduced from 6.81±1.17 kPa during supervised inpatient set-up to 5.93±0.82 kPa after NIV set-up (p<0.001). NIV adherence reduced from 7.8 (range: 1.0–11.0) h per 24 h during supervised inpatient set-up to 2.9 (0–10.4) h per 24 h in the community. Overall 72% of patients used NIV <5 h per 24 h during follow-up, including 11% who discontinued NIV completely. There was no correlation between adherence to NIV and changes in capillary PCO2. Patients who reported symptomatic benefit (50%) had higher adherence than those who did not feel benefit (p<0.05). In conclusion, in patients with myotonic dystrophy with Type II respiratory failure maintaining adherence is challenging. Commencing patients with myotonic dystrophy on noninvasive ventilation appears to reverse respiratory failure despite poor adherence to ventilationhttps://bit.ly/343XUGK
Collapse
Affiliation(s)
- Vilma Rautemaa
- School of Medical Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
| | - Mark E Roberts
- Dept of Neurology, Greater Manchester Neurosciences Centre, Salford Royal NHS Foundation Trust, Salford, UK
| | - Andrew Bentley
- North West Ventilation Unit, Manchester University NHS Foundation Trust, Manchester, UK.,Division of Infection, Immunity and Respiratory Medicine, School of Biological Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
| | - Timothy W Felton
- North West Ventilation Unit, Manchester University NHS Foundation Trust, Manchester, UK.,Division of Infection, Immunity and Respiratory Medicine, School of Biological Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
| |
Collapse
|
6
|
Vosse BAH, Seijger C, Cobben N, van Engelen B, van Kuijk SMJ, Faber C, Wijkstra P. Noninvasive Home Mechanical Ventilation in Adult Myotonic Dystrophy Type 1: A Systematic Review. Respiration 2021; 100:816-825. [PMID: 33965950 DOI: 10.1159/000515453] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Accepted: 02/12/2021] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION Chronic hypercapnic respiratory failure induces considerable morbidity and mortality in patients with myotonic dystrophy type 1 (DM1). This study systematically reviews the effects of noninvasive home mechanical ventilation (HMV) on gas exchange, quality of life, survival, and compliance in DM1 patients. METHODS A systematic Medline and Embase search was performed (January 1995 to January 2020). Records were screened for eligibility criteria, data were extracted from included studies, and risk of bias was assessed. We present findings mainly using a narrative synthesis. RESULTS Twenty-eight relevant full-text articles were screened for eligibility criteria. Nine studies were included. Randomized controlled trials were not found. Studies had either an observational (n = 8) or interventional (n = 1) design. In the pooled data analysis, HMV showed to improve mean oxygen saturation with 4.8% and decreased mean carbon dioxide values with 3 mm Hg. Compliance varied widely between studies, from no use to more than 12 h per day. Quality of life was not studied extensively, but some studies reported positive effects of HMV on symptoms of chronic respiratory failure. HMV may improve survival in DM1 patients with chronic hypercapnic respiratory failure. CONCLUSION This review shows that HMV can improve gas exchange and relieve symptoms with a possible survival benefit in DM1 patients with chronic hypercapnic respiratory failure. Future studies should focus on developing strategies to optimize the timing of HMV initiation and to promote compliance.
Collapse
Affiliation(s)
- Bettine A H Vosse
- Department of Pulmonary Diseases and Home Mechanical Ventilation, Maastricht University Medical Center+, Maastricht, The Netherlands
| | - Charlotte Seijger
- Department of Pulmonary Diseases and Home Mechanical Ventilation, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Nicolle Cobben
- Department of Pulmonary Diseases and Home Mechanical Ventilation, Maastricht University Medical Center+, Maastricht, The Netherlands
| | - Baziel van Engelen
- Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Radboud University Nijmegen, Nijmegen, The Netherlands
| | - Sander M J van Kuijk
- Department of Clinical Epidemiology and Medical Technology Assessment, Maastricht University Medical Center+, Maastricht, The Netherlands
| | - Catharina Faber
- Department of Neurology, School of Mental Health and Neuroscience, Maastricht University Medical Center+, Maastricht, The Netherlands
| | - Peter Wijkstra
- Department of Pulmonary Diseases and Home Mechanical Ventilation, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| |
Collapse
|
7
|
Rao F, Garuti G, Vitacca M, Banfi P, Racca F, Cutrera R, Pavone M, Pedemonte M, Schisano M, Pedroni S, Casiraghi J, Vianello A, Sansone VA. Management of respiratory complications and rehabilitation in individuals with muscular dystrophies: 1st Consensus Conference report from UILDM - Italian Muscular Dystrophy Association (Milan, January 25-26, 2019). ACTA MYOLOGICA : MYOPATHIES AND CARDIOMYOPATHIES : OFFICIAL JOURNAL OF THE MEDITERRANEAN SOCIETY OF MYOLOGY 2021; 40:8-42. [PMID: 33870094 PMCID: PMC8033426 DOI: 10.36185/2532-1900-045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Accepted: 03/16/2021] [Indexed: 12/03/2022]
Abstract
Respiratory complications are common in the patient with muscular dystrophy. The periodic clinical and instrumental respiratory evaluation is extremely important. Despite the presence in the literature of updated guidelines, patient associations often report lack of knowledge of these pathologies, particularly in peripheral hospitals. The purpose of this work, inspired by the Italian Muscular Dystrophy Association (UILDM) is to improve management of respiratory problems necessary for the management of these patients complex. To this end, the main items that the specialist can meet in the follow-up of these pathologies have been analyzed and discussed, among which the respiratory basal evaluation, the criteria of adaptation to non-invasive ventilation, management of bronchial secretions, situations of respiratory emergency, indications for tracheostomy and the subject of advance directives of treatment (DAT).
Collapse
Affiliation(s)
- Fabrizio Rao
- Respiratory Unit, NEuroMuscular OmniCentre (NeMO), Serena Onlus Foundation, Niguarda Hospital, Milan, Italy
| | - Giancarlo Garuti
- Pneumology Unit, Santa Maria Bianca Hospital, AUSL Modena, Italy
| | | | - Paolo Banfi
- IRCCS Fondazione Don Carlo Gnocchi, Milan, Italy
| | - Fabrizio Racca
- Department of Anaesthesia and Intensive Care, Division of Paediatric Intensive Care Unit, Alessandria General Hospital, Alessandria, Italy
| | - Renato Cutrera
- Pulmonology Unit, Academic Paediatric Department, Bambino Gesù Children Hospital, IRCCS, Rome, Italy
| | - Martino Pavone
- Pediatric Pulmonology & Respiratory Intermediate Care Unit, Sleep and Long Term Ventilation Unit, Department of Pediatrics, Bambino Gesù Children’s Research Hospital, Rome, Italy
| | - Marina Pedemonte
- Pediatric Neurology and Muscle Diseases Unit, IRCCS Istituto Giannina Gaslini, Genoa, Italy
| | - Matteo Schisano
- Respiratory Medicine Unit, AOU “Policlinico-San Marco”, Catania, Italy
| | - Stefania Pedroni
- Neurorehabilitation Unit, the NEMO Clinical Center in Milan, University of Milan, Italy
| | - Jacopo Casiraghi
- Neurorehabilitation Unit, the NEMO Clinical Center in Milan, University of Milan, Italy
| | - Andrea Vianello
- Respiratory Pathophysiology Division, Department of Cardiac, Thoracic and Vascular Sciences, University of Padua, Italy
| | - Valeria A Sansone
- Neurorehabilitation Unit, the NEMO Clinical Center in Milan, University of Milan, Italy
| |
Collapse
|
8
|
Seijger C, Raaphorst J, Vonk J, van Engelen B, Heijerman H, Stigter N, Wijkstra P. New Insights in Adherence and Survival in Myotonic Dystrophy Patients Using Home Mechanical Ventilation. Respiration 2021; 100:154-163. [PMID: 33461194 DOI: 10.1159/000511962] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2020] [Accepted: 09/07/2020] [Indexed: 01/14/2023] Open
Abstract
BACKGROUND Non-invasive home mechanical ventilation (HMV) is a complex treatment in myotonic dystrophy type 1 (DM1) patients, due to a presumed poor adherence, variable symptom improvement, and uncertainty regarding survival benefits. OBJECTIVES We aimed to investigate indications, adherence to HMV and its effects on mortality in a large cohort of DM1 patients. METHODS In this retrospective cohort study, we evaluated 224 DM1 patients. Different groups based on hypercapnia and HMV treatment were compared. Cox regression analyses were performed to compare mortality between different defined groups. RESULTS 224 patients were analysed of whom 111 started non-invasive HMV. Indications were daytime hypercapnia (n = 75), only nocturnal hypercapnia (n = 33), or other reasons (n = 3). Adequate adherence (≥4 h/night) was found in 84.9% of patients. Adequate ventilation was reached in 86.5% of patients. In 33 patients (29.7%), HMV was stopped prematurely due to not reaching patients' expectations on symptom relief or treatment burden (n = 22), or intolerance (n = 8), or other reasons (n = 3). HMV did not improve survival in daytime hypercapnic patients (p = 0.61) nor in nocturnal hypercapnia patients compared to daytime hypercapnia (p = 0.21). Significant survival benefits after starting HMV were found for patients with HMV adherence ≥5 h/24 h compared to patients who used HMV less. CONCLUSION In this large cohort, daytime hypercapnia is the main reason for starting HMV, which is well tolerated and used. Mortality is not associated with the reason why HMV was started, but once started, patients with ≥5 h/24 h adherence have significantly better survival compared to patients who use it less.
Collapse
Affiliation(s)
- Charlotte Seijger
- Department of Pulmonary Diseases and Home Mechanical Ventilation, University of Groningen, University Medical Centre Groningen, Groningen, The Netherlands,
| | - Joost Raaphorst
- Department of Neurology, Amsterdam Neuroscience, University of Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands
| | - Judith Vonk
- Department of Epidemiology, University of Groningen, University Medical Centre Groningen, Groningen, The Netherlands
| | - Baziel van Engelen
- Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Harry Heijerman
- Department of Pulmonary Diseases, Utrecht University, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - Nadine Stigter
- Department of Pulmonary Diseases, Utrecht University, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - Peter Wijkstra
- Department of Pulmonary Diseases and Home Mechanical Ventilation, University of Groningen, University Medical Centre Groningen, Groningen, The Netherlands
| |
Collapse
|
9
|
Effects of nasal high flow on nocturnal hypercapnia, sleep, and sympathovagal balance in patients with neuromuscular disorders. Sleep Breath 2020; 25:1441-1451. [PMID: 33263819 PMCID: PMC7708892 DOI: 10.1007/s11325-020-02263-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Revised: 10/24/2020] [Accepted: 11/24/2020] [Indexed: 12/11/2022]
Abstract
PURPOSE In neuromuscular disorders (NMD), inspiratory muscle weakness may cause sleep-related hypoventilation requiring non-invasive ventilation (NIV). Alternatively, nasal high flow therapy (NHF) may ameliorate mild nocturnal hypercapnia (NH) through washout of anatomical dead space and generation of positive airway pressure. Ventilatory support by NIV or NHF might have favourable short-term effects on sympathovagal balance (SVB). This study comparatively investigated the effects of NHF and NIV on sleep-related breathing and SVB in NMD patients with evolving NH. METHODS Transcutaneous CO2 (ptcCO2), peripheral oxygen saturation (SpO2), sleep outcomes and SVB (spectral analysis of heart rate, diastolic blood pressure variability) along with haemodynamic measures (cardiac index, total peripheral resistance index) were evaluated overnight in 17 patients. Polysomnographies (PSG) were randomly split into equal parts with no treatment, NIV and NHF at different flow rates (20 l/min vs. 50 l/min). In-depth analysis of SVB and haemodynamics was performed on 10-min segments of stable N2 sleep taken from each intervention. RESULTS Compared with no treatment, NHF20 and NHF50 did not significantly change ptcCO2, SpO2 or the apnea hypopnea index (AHI). NHF50 was poorly tolerated. In contrast, NIV significantly improved both gas exchange and AHI without adversely affecting sleep. During daytime, NHF20 and NHF50 had neutral effects on ventilation and oxygenation whereas NIV improved ptcCO2 and SpO2. Effects of NIV and NHF on SVB and haemodynamics were neutral during both night and daytime. CONCLUSIONS NHF does not correct sleep-disordered breathing in NMD patients with NH. Both NHF and NIV exert no immediate effects on SVB.
Collapse
|
10
|
Miller JN, van der Plas E, Hamilton M, Koscik TR, Gutmann L, Cumming SA, Monckton DG, Nopoulos PC. Variant repeats within the DMPK CTG expansion protect function in myotonic dystrophy type 1. NEUROLOGY-GENETICS 2020; 6:e504. [PMID: 32851192 PMCID: PMC7428360 DOI: 10.1212/nxg.0000000000000504] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/19/2020] [Accepted: 07/09/2020] [Indexed: 01/10/2023]
Abstract
Objective We tested the hypothesis that variant repeat interruptions (RIs) within the DMPK CTG repeat tract lead to milder symptoms compared with pure repeats (PRs) in myotonic dystrophy type 1 (DM1). Methods We evaluated motor, neurocognitive, and behavioral outcomes in a group of 6 participants with DM1 with RI compared with a case-matched sample of 12 participants with DM1 with PR and a case-matched sample of 12 unaffected healthy comparison participants (UA). Results In every measure, the RI participants were intermediate between UA and PR participants. For muscle strength, the RI group was significantly less impaired than the PR group. For measures of Full Scale IQ, depression, and sleepiness, all 3 groups were significantly different from each other with UA > RI > PR in order of impairment. The RI group was different from unaffected, but not significantly different from PR (UA > RI = PR) in apathy and working memory. Finally, in finger tapping and processing speed, RI did not differ from UA comparisons, but PR had significantly lower scores than the UA comparisons (UA = RI > PR). Conclusions Our results support the notion that patients affected by DM1 with RI demonstrate a milder phenotype with the same pattern of deficits as those with PR indicating a similar disease process.
Collapse
Affiliation(s)
- Jacob N Miller
- Department of Psychiatry (J.N.M., E.P., T.R.K., P.C.N.), University of Iowa Hospitals and Clinics; West of Scotland Clinical Genetics Service (M.H.), Queen Elizabeth University Hospital; Institute of Molecular, Cell and Systems Biology (M.H., S.A.C., D.G.M.), College of Medical, Veterinary and Life Sciences, University of Glasgow, United Kingdom; and Department of Neurology (L.G.), University of Iowa Hospitals and Clinics
| | - Ellen van der Plas
- Department of Psychiatry (J.N.M., E.P., T.R.K., P.C.N.), University of Iowa Hospitals and Clinics; West of Scotland Clinical Genetics Service (M.H.), Queen Elizabeth University Hospital; Institute of Molecular, Cell and Systems Biology (M.H., S.A.C., D.G.M.), College of Medical, Veterinary and Life Sciences, University of Glasgow, United Kingdom; and Department of Neurology (L.G.), University of Iowa Hospitals and Clinics
| | - Mark Hamilton
- Department of Psychiatry (J.N.M., E.P., T.R.K., P.C.N.), University of Iowa Hospitals and Clinics; West of Scotland Clinical Genetics Service (M.H.), Queen Elizabeth University Hospital; Institute of Molecular, Cell and Systems Biology (M.H., S.A.C., D.G.M.), College of Medical, Veterinary and Life Sciences, University of Glasgow, United Kingdom; and Department of Neurology (L.G.), University of Iowa Hospitals and Clinics
| | - Timothy R Koscik
- Department of Psychiatry (J.N.M., E.P., T.R.K., P.C.N.), University of Iowa Hospitals and Clinics; West of Scotland Clinical Genetics Service (M.H.), Queen Elizabeth University Hospital; Institute of Molecular, Cell and Systems Biology (M.H., S.A.C., D.G.M.), College of Medical, Veterinary and Life Sciences, University of Glasgow, United Kingdom; and Department of Neurology (L.G.), University of Iowa Hospitals and Clinics
| | - Laurie Gutmann
- Department of Psychiatry (J.N.M., E.P., T.R.K., P.C.N.), University of Iowa Hospitals and Clinics; West of Scotland Clinical Genetics Service (M.H.), Queen Elizabeth University Hospital; Institute of Molecular, Cell and Systems Biology (M.H., S.A.C., D.G.M.), College of Medical, Veterinary and Life Sciences, University of Glasgow, United Kingdom; and Department of Neurology (L.G.), University of Iowa Hospitals and Clinics
| | - Sarah A Cumming
- Department of Psychiatry (J.N.M., E.P., T.R.K., P.C.N.), University of Iowa Hospitals and Clinics; West of Scotland Clinical Genetics Service (M.H.), Queen Elizabeth University Hospital; Institute of Molecular, Cell and Systems Biology (M.H., S.A.C., D.G.M.), College of Medical, Veterinary and Life Sciences, University of Glasgow, United Kingdom; and Department of Neurology (L.G.), University of Iowa Hospitals and Clinics
| | - Darren G Monckton
- Department of Psychiatry (J.N.M., E.P., T.R.K., P.C.N.), University of Iowa Hospitals and Clinics; West of Scotland Clinical Genetics Service (M.H.), Queen Elizabeth University Hospital; Institute of Molecular, Cell and Systems Biology (M.H., S.A.C., D.G.M.), College of Medical, Veterinary and Life Sciences, University of Glasgow, United Kingdom; and Department of Neurology (L.G.), University of Iowa Hospitals and Clinics
| | - Peggy C Nopoulos
- Department of Psychiatry (J.N.M., E.P., T.R.K., P.C.N.), University of Iowa Hospitals and Clinics; West of Scotland Clinical Genetics Service (M.H.), Queen Elizabeth University Hospital; Institute of Molecular, Cell and Systems Biology (M.H., S.A.C., D.G.M.), College of Medical, Veterinary and Life Sciences, University of Glasgow, United Kingdom; and Department of Neurology (L.G.), University of Iowa Hospitals and Clinics
| |
Collapse
|
11
|
Boentert M, Cao M, Mass D, De Mattia E, Falcier E, Goncalves M, Holland V, Katz SL, Orlikowski D, Sannicolò G, Wijkstra P, Hellerstein L, Sansone VA. Consensus-Based Care Recommendations for Pulmonologists Treating Adults with Myotonic Dystrophy Type 1. Respiration 2020; 99:360-368. [PMID: 32299079 DOI: 10.1159/000505634] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2019] [Accepted: 12/24/2019] [Indexed: 11/19/2022] Open
Abstract
PURPOSE OF REVIEW Myotonic dystrophy type 1 (DM1) is a severe, progressive genetic disease that affects approximately 1 in 2,500 individuals globally [Ashizawa et al.: Neurol Clin Pract 2018;8(6):507-20]. In patients with DM1, respiratory muscle weakness frequently evolves, leading to respiratory failure as the main cause of death in this patient population, followed by cardiac complications [de Die-Smulders et al.: Brain 1998;121(Pt 8):1557-63], [Mathieu et al.: Neurology 1999;52(8):1658-62], [Groh et al.: Muscle Nerve 2011;43(5):648-51]. This paper provides a more detailed outline on the diagnostic and management protocols, which can guide pulmonologists who may not have experience with DM1 or who are not part of a neuromuscular multidisciplinary clinic. A group of neuromuscular experts in DM1 including pulmonologists, respiratory physiotherapists and sleep specialists discussed respiratory testing and management at baseline and during follow-up visits, based on their clinical experience with patients with DM1. The details are presented in this report. RECENT FINDINGS Myotonic recruited 66 international clinicians experienced in the treatment of people living with DM1 to develop and publish consensus-based care recommendations targeting all body systems affected by this disease [Ashizawa et al.: Neurol Clin Pract. 2018;8(6):507-20]. Myotonic then worked with 12 international respiratory therapists, pulmonologists and neurologists with long-standing experience in DM respiratory care to develop consensus-based care recommendations for pulmonologists using a methodology called the Single Text Procedure. This process generated a 7-page document that provides detailed respiratory care recommendations for the management of patients living with DM1. This consensus is completely based on expert opinion and not backed up by empirical evidence due to limited clinical care data available for respiratory care management in DM patients. Nevertheless, we believe it is of relevance for professionals treating adults with myotonic dystrophy because it addresses practical issues related to respiratory management and care, which have been adapted to meet the specific issues in patients with DM1. SUMMARY The resulting recommendations are intended to improve respiratory care for the most vulnerable of DM1 patients and lower the risk of untoward respiratory complications and mortality by providing pulmonologist who are less experienced with DM1 with practical indications on which tests and when to perform them, adapting the general respiratory knowledge to specific issues related to this multiorgan disease.
Collapse
Affiliation(s)
| | | | - Daphne Mass
- Radboud University, Nijmegen, The Netherlands
| | - Elisa De Mattia
- The NEMO Clinical Center (NEuroMuscular Omniservice), University of Milan, Milan, Italy
| | - Elisa Falcier
- The NEMO Clinical Center (NEuroMuscular Omniservice), University of Milan, Milan, Italy
| | | | - Venessa Holland
- Houston Methodist Neurological Institute, Houston, Texas, USA
| | | | | | - Giulia Sannicolò
- The NEMO Clinical Center (NEuroMuscular Omniservice), University of Milan, Milan, Italy
| | - Peter Wijkstra
- University Medical Centre Groningen, Groningen, The Netherlands
| | | | - Valeria A Sansone
- The NEMO Clinical Center (NEuroMuscular Omniservice), University of Milan, Milan, Italy
| |
Collapse
|
12
|
Landfeldt E, Edström J, Jimenez-Moreno C, van Engelen BGM, Kirschner J, Lochmüller H. Health-Related Quality of Life in Patients with Adult-Onset Myotonic Dystrophy Type 1: A Systematic Review. PATIENT-PATIENT CENTERED OUTCOMES RESEARCH 2020; 12:365-373. [PMID: 30714084 PMCID: PMC6598969 DOI: 10.1007/s40271-019-00357-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Background Adult-onset myotonic dystrophy type 1 (DM1) is a chronic, multisystem disorder that leads to disability and premature death. Objectives The objective of our study was to conduct a systematic literature review of the health-related quality of life (HRQoL) of patients with DM1. Methods We searched Embase, Web of Science, and PubMed for English language full-text articles reporting results from studies of HRQoL in patients with adult-onset DM1 published between 1 January 2000 and 21 February 2018. We excluded reviews, editorials, and studies reporting results for a sample with fewer than five patients (to allow for meaningful inference). Results The search identified 266 unique publications. Of these, 231 were excluded following title and abstract screening and 16 after full-text review, leaving 19 articles for data synthesis. We found 15 articles measuring the HRQoL of patients with adult-onset DM1 using the 36-Item Short Form Health Survey (SF-36), six using the Individualized Neuromuscular Quality of Life Questionnaire (INQoL), and one using Cantril’s Ladder. Available evidence shows that patient HRQoL is impaired in DM1, mainly due to compromised physical health, but also reveals that substantial heterogeneity exists in estimates across studies. Conclusions HRQoL in adult-onset DM1 has been extensively studied using the SF-36 and the INQoL, but current estimates are inconclusive, and little is known of the impact of the disease as measured using other instruments. Our data synthesis should help characterize the patient burden of DM1 and inform future studies of HRQoL in this indication. Electronic supplementary material The online version of this article (10.1007/s40271-019-00357-y) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- Erik Landfeldt
- Institute of Environmental Medicine, Karolinska Institutet, Nobels väg 13, 17177, Stockholm, Sweden.
- ICON plc, Stockholm, Sweden.
| | | | | | - Baziel G M van Engelen
- Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Janbernd Kirschner
- Department of Neuropediatrics and Muscle Disorders, Medical Centre, University of Freiburg, Faculty of Medicine, Freiburg, Germany
| | - Hanns Lochmüller
- Department of Neuropediatrics and Muscle Disorders, Medical Centre, University of Freiburg, Faculty of Medicine, Freiburg, Germany
- Children's Hospital of Eastern Ontario Research Institute, University of Ottawa, Ottawa, Canada
- Division of Neurology, Department of Medicine, The Ottawa Hospital, Ottawa, ON, Canada
| |
Collapse
|
13
|
Yetimakman AF, Bayrakçı B, Esquinas AM. Myotonic Dystrophy type 1, individualised respiratory care rather than standart prognostication. J Neurol Sci 2019; 401:125-126. [DOI: 10.1016/j.jns.2019.04.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2019] [Accepted: 04/15/2019] [Indexed: 10/27/2022]
|
14
|
Rossi S, Silvestri G. Letter of response to “Myotonic dystrophy type 1, individualised respiratory care rather than standart prognostication”. J Neurol Sci 2019; 401:66. [DOI: 10.1016/j.jns.2019.04.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2019] [Accepted: 04/15/2019] [Indexed: 11/24/2022]
|
15
|
Baillieul S, Revol B, Jullian-Desayes I, Joyeux-Faure M, Tamisier R, Pépin JL. Diagnosis and management of central sleep apnea syndrome. Expert Rev Respir Med 2019; 13:545-557. [PMID: 31014146 DOI: 10.1080/17476348.2019.1604226] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Introduction: Central sleep apnea (CSA) syndrome has gained a considerable interest in the sleep field within the last 10 years. It is overrepresented in particular subpopulations such as patients with stroke or heart failure. Early detection and diagnosis, as well as appropriate treatment of central breathing disturbances during sleep remain challenging. Areas covered: Based on a systematic review of CSA in adults the clinical evidence and polysomnographic patterns useful for discerning central from obstructive events are discussed. Current therapeutic indications of CSA and perspectives are presented, according to the type of respiratory disturbances during sleep, alterations in blood gases and ventilatory control. Expert opinion: The precise identification of central events during polysomnographic recording is mandatory. Therapeutic choices for CSA depend on the typology of respiratory disturbances observed by polysomnography, changes in blood gases and ventilatory control. In CSA with normocapnia and ventilatory instability, adaptive servo-ventilation is recommended. In CSA with hypercapnia and/or rapid-eye movement sleep hypoventilation, non-invasive ventilation is required. Further studies are required as strong evidence is lacking regarding the long-term consequences of CSA and the long-term impact of current treatment strategies.
Collapse
Affiliation(s)
- Sébastien Baillieul
- a Grenoble Alpes University , HP2 Laboratory , INSERM U1042, Grenoble , France.,b Pôle Thorax et Vaisseaux , Grenoble Alpes University Hospital , Grenoble , France
| | - Bruno Revol
- a Grenoble Alpes University , HP2 Laboratory , INSERM U1042, Grenoble , France.,b Pôle Thorax et Vaisseaux , Grenoble Alpes University Hospital , Grenoble , France
| | - Ingrid Jullian-Desayes
- a Grenoble Alpes University , HP2 Laboratory , INSERM U1042, Grenoble , France.,b Pôle Thorax et Vaisseaux , Grenoble Alpes University Hospital , Grenoble , France
| | - Marie Joyeux-Faure
- a Grenoble Alpes University , HP2 Laboratory , INSERM U1042, Grenoble , France.,b Pôle Thorax et Vaisseaux , Grenoble Alpes University Hospital , Grenoble , France
| | - Renaud Tamisier
- a Grenoble Alpes University , HP2 Laboratory , INSERM U1042, Grenoble , France.,b Pôle Thorax et Vaisseaux , Grenoble Alpes University Hospital , Grenoble , France
| | - Jean-Louis Pépin
- a Grenoble Alpes University , HP2 Laboratory , INSERM U1042, Grenoble , France.,b Pôle Thorax et Vaisseaux , Grenoble Alpes University Hospital , Grenoble , France
| |
Collapse
|
16
|
Sleep-disordered breathing and effects of non-invasive ventilation on objective sleep and nocturnal respiration in patients with myotonic dystrophy type I. Neuromuscul Disord 2019; 29:302-309. [PMID: 30898523 DOI: 10.1016/j.nmd.2019.02.006] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2018] [Revised: 01/26/2019] [Accepted: 02/12/2019] [Indexed: 12/21/2022]
Abstract
Patients with myotonic dystrophy type I (DM1) may develop nocturnal hypoventilation, requiring non-invasive ventilation. Data on long-term adherence to non-invasive ventilation, or sleep and ventilation outcomes are scarce. We retrospectively collected baseline polysomnography and capnometry results from 36 adult patients with sleep-related symptoms (42.9 ± 12.5 years, 20 female), plus follow-up sleep study records from those treated with non-invasive ventilation. Sleep-disordered breathing was found in 33 patients (91.7%) including 8 (22.2%) with daytime hypercapnia. Twenty-six patients (72.2%) showed nocturnal hypoventilation on transcutaneous capnometry. The sensitivity of oximetry to detect nocturnal hypoventilation was only 0.38. Twenty-eight patients (77.8%) showed sleep apnea, which was predominantly obstructive (n = 8), central (n = 9), or "mixed" (n = 11). Thirty-two patients were initiated on non-invasive ventilation which significantly improved ventilation and oxygenation in the first night of treatment. Follow-up revealed stable normoxia and normocapnia without deterioration of sleep outcomes for up to 52 months. Adherence to treatment was low to moderate, with substantial inter-individual variability. Sleep disordered breathing is highly prevalent in adult DM1 patients complaining of daytime sleepiness, and non-invasive ventilation significantly, rapidly and persistently improves nocturnal gas exchange. Capnometry is superior to oximetry for detection of nocturnal hypoventilation. Adherence to non-invasive ventilation remains a major issue in DM1, and long-term treatment benefits should be individually assessed.
Collapse
|
17
|
Hawkins AM, Hawkins CL, Abdul Razak K, Khoo TK, Tran K, Jackson RV. Respiratory dysfunction in myotonic dystrophy type 1: A systematic review. Neuromuscul Disord 2018; 29:198-212. [PMID: 30765255 DOI: 10.1016/j.nmd.2018.12.002] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2018] [Revised: 12/02/2018] [Accepted: 12/06/2018] [Indexed: 11/28/2022]
Abstract
Myotonic dystrophy type 1 (DM1) is one of the most common muscular dystrophies in adults. This review summarises the current literature regarding the natural history of respiratory dysfunction in DM1, the role of central respiratory drive and peripheral respiratory muscle involvement and its significance in respiratory function, and investigates the relationship between genetics (CTG repeat length) and respiratory dysfunction. The review included all articles that reported spirometry on 10 or more myotonic dystrophy patients. The final review included 55 articles between 1964 and 2017. The major conclusions of this review were (1) confirmation of the current consensus that respiratory dysfunction, predominantly a restrictive ventilatory pattern, is common in myotonic dystrophy and is associated with alveolar hypoventilation, chronic hypercapnia, and sleep disturbance in the form of sleep apnoea and sleep related disordered breathing; (2) contrary to commonly held belief, there is no consensus in the literature regarding the relationship between CTG repeat length and severity of respiratory dysfunction and a relationship has not been established; (3) the natural history and time-course of respiratory functional decline is very poorly understood in the current literature; (4) there is a consensus that there is a significant involvement of central respiratory drive in this alveolar hypoventilation however the current literature does not identify the mechanism for this.
Collapse
Affiliation(s)
- A M Hawkins
- School of Medicine, Griffith University, Gold Coast, Queensland, Australia; Department of Medicine, Logan Hospital, Meadowbrook, Queensland, Australia.
| | - C L Hawkins
- School of Medicine, University of Queensland, St Lucia, Queensland, Australia
| | - K Abdul Razak
- School of Medicine, Griffith University, Gold Coast, Queensland, Australia; Department of Medicine, Logan Hospital, Meadowbrook, Queensland, Australia
| | - T K Khoo
- School of Medicine, Griffith University, Gold Coast, Queensland, Australia; School of Medicine, University of Wollongong, New South Wales, Australia
| | - K Tran
- School of Medicine, Griffith University, Gold Coast, Queensland, Australia; School of Medicine, University of Queensland, St Lucia, Queensland, Australia; Department of Respiratory Medicine, Logan Hospital, Meadowbrook, Queensland, Australia
| | - R V Jackson
- School of Medicine, Griffith University, Gold Coast, Queensland, Australia; Department of Medicine, Logan Hospital, Meadowbrook, Queensland, Australia
| |
Collapse
|
18
|
Boussaïd G, Prigent H, Laforet P, Raphaël JC, Annane D, Orlikowski D, Lofaso F. Effect and impact of mechanical ventilation in myotonic dystrophy type 1: a prospective cohort study. Thorax 2018; 73:1075-1078. [PMID: 29572271 DOI: 10.1136/thoraxjnl-2017-210610] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2017] [Revised: 01/25/2018] [Accepted: 01/29/2018] [Indexed: 01/01/2023]
Abstract
Few studies have assessed the impact of home ventilation in patients with myotonic dystrophy type 1 (DM1) and no specific recommendations are available. We assessed the survival associated with category of home ventilation adherence of patients with DM1 followed up at a home ventilation unit using a Cox proportional hazards model. 218 patients were included; those who refused or delayed their acceptance of non-invasive ventilation were at higher risk for severe events (invasive ventilation or death) (P=0.03). Risk of death was associated with orthopnoea (HR 2.37; 95% CI 1.17 to 4.80; P<0.02) and adherence category (100 to 90% vs >75%: HR 3.26; 95% CI 1.32 to 8.04; P<0.03). Failure to use home ventilation as prescribed may be associated with increased mortality in patients with DM1.
Collapse
Affiliation(s)
- Ghilas Boussaïd
- CIC 1429, INSERM, AP-HP, Hôpital Raymond Poincaré, Garches, France.,Association Française contre les Myopathies-Téléthon, Évry, France.,Université de Versailles Saint-Quentin-en-Yvelines, INSERM U1179, Versailles, France
| | - Hélène Prigent
- Université de Versailles Saint-Quentin-en-Yvelines, INSERM U1179, Versailles, France.,Service d'Explorations Fonctionnelles Respiratoires, AP-HP, Hôpital Raymond Poincaré, Garches, France
| | - Pascal Laforet
- Institut de Myologie, Centre de Référence de Pathologie Neuromusculaire Paris-Est, GH Pitié-Salpêtrière, Paris, France
| | - Jean-Claude Raphaël
- Pôle de ventilation à domicile, AP-HP, Hôpital Raymond Poincaré, Garches, France
| | - Djillali Annane
- CIC 1429, INSERM, AP-HP, Hôpital Raymond Poincaré, Garches, France.,Université de Versailles Saint-Quentin-en-Yvelines, INSERM U1179, Versailles, France.,Pôle de ventilation à domicile, AP-HP, Hôpital Raymond Poincaré, Garches, France
| | - David Orlikowski
- CIC 1429, INSERM, AP-HP, Hôpital Raymond Poincaré, Garches, France.,Université de Versailles Saint-Quentin-en-Yvelines, INSERM U1179, Versailles, France.,Pôle de ventilation à domicile, AP-HP, Hôpital Raymond Poincaré, Garches, France
| | - Frédéric Lofaso
- Association Française contre les Myopathies-Téléthon, Évry, France.,Université de Versailles Saint-Quentin-en-Yvelines, INSERM U1179, Versailles, France.,Service d'Explorations Fonctionnelles Respiratoires, AP-HP, Hôpital Raymond Poincaré, Garches, France
| |
Collapse
|
19
|
Piper AJ, Wort SJ, Renzoni EA, Kouranos V. Year in review 2017: Interstitial lung disease, pulmonary vascular disease and sleep. Respirology 2018; 23:421-433. [PMID: 29471594 DOI: 10.1111/resp.13273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2018] [Accepted: 02/01/2018] [Indexed: 12/01/2022]
Affiliation(s)
- Amanda J Piper
- Department of Respiratory and Sleep Medicine, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia.,Central Clinical School, University of Sydney, Sydney, New South Wales, Australia
| | - Stephen J Wort
- Pulmonary Hypertension Department, Royal Brompton Hospital, Imperial College, London, UK
| | - Elisabetta A Renzoni
- Interstitial Lung Disease Unit, Royal Brompton Hospital, Imperial College, London, UK
| | - Vasileios Kouranos
- Interstitial Lung Disease Unit, Royal Brompton Hospital, Imperial College, London, UK
| |
Collapse
|
20
|
Priou P, Trzepizur W, Meslier N, Gagnadoux F. [Update on the respiratory management of patients with chronic neuromuscular disease]. REVUE DE PNEUMOLOGIE CLINIQUE 2017; 73:316-322. [PMID: 29174288 DOI: 10.1016/j.pneumo.2017.10.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/06/2017] [Revised: 10/02/2017] [Accepted: 10/04/2017] [Indexed: 06/07/2023]
Abstract
BACKGROUND Neuromuscular diseases include a wide range of conditions that may involve potentially life-threatening respiratory complications (infection, respiratory failure). SURVEILLANCE AND PULMONARY FUNCTION TESTS For patients with neuromuscular diseases, clinical assessment of respiratory function and regular pulmonary function tests are needed to screen for nocturnal respiratory disorders, weakness of the diaphragm and potential restrictive disorders and/or chronic hypercapnic respiratory insufficiency, possibly with couch deficiency. MANAGEMENT OF NOCTURNAL RESPIRATORY DISORDERS AND CHRONIC RESPIRATORY FAILURE: Nocturnal respiratory assistance is an important phase of care for nocturnal respiratory disorders and chronic respiratory failure. This may involve continuous positive airway pressure, adaptative servo-ventilation or non-invasive ventilation with a facial or nasal mask. As needed, diurnal assistance may be proposed by mouthpiece ventilation. Should non-invasive ventilation prove insufficient, or if significant swallowing disorders or recurrent bronchial obstruction develop, or in case of prolonged intubation, tracheotomy may be required. LOWER AIRWAY OBSTRUCTION In case of lower airway infection with ineffective cough, physical therapy, associated with air stacking, intermittent positive pressure breathing or mechanical in-exsufflation may be proposed. PATIENT-CENTERED MANAGEMENT Care for swallowing disorders, nutritional counseling (cachexia, obesity), vaccinations and therapeutic education are integral elements of patient-centered management aiming to prevent the negative impact of infection and to manage respiratory failure of chronic neuromuscular disease.
Collapse
Affiliation(s)
- P Priou
- Département de pneumologie, CHU d'Angers, 4, rue Larrey, 49933 Angers, France; Centre de référence des maladies neuromusculaires, CHU d'Angers, 4, rue Larrey, 49933 Angers, France.
| | - W Trzepizur
- Département de pneumologie, CHU d'Angers, 4, rue Larrey, 49933 Angers, France
| | - N Meslier
- Département de pneumologie, CHU d'Angers, 4, rue Larrey, 49933 Angers, France; Centre de référence sur la sclérose latérale amyotrophique, CHU d'Angers, 4, rue Larrey, 49933 Angers, France
| | - F Gagnadoux
- Département de pneumologie, CHU d'Angers, 4, rue Larrey, 49933 Angers, France
| |
Collapse
|
21
|
Boentert M. Dissecting the benefits of long-term non-invasive ventilation in patients with distinct neuromuscular disorders. Respirology 2017. [DOI: 10.1111/resp.13103] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Affiliation(s)
- Matthias Boentert
- Department of Sleep Medicine and Neuromuscular Disorders; University Hospital Münster; Münster Germany
| |
Collapse
|