title: Ventilator weaning by lung expansion and decannulation.
abstract: This case series of ventilator-dependent patients with neuromuscular disease who had no ventilator-free breathing ability demonstrates that decannulation and switching to continuous noninvasive intermittent positive-pressure ventilation combined with regular lung expansion therapy can result in improvements in pulmonary function and at least partial ventilator weaning. These six patients were also managed using mechanical insufflation-exsufflation for regular lung expansion and cough assistance. Thus, some ventilator users with neuromuscular disease can benefit from tracheostomy tube decannulation and transition to noninvasive intermittent positive-pressure ventilation and assisted coughing for ventilator weaning to predominantly nocturnal-only use.
authors.affiliation: Department of Physical Medicine and Rehabilitation, University of Medicine and Dentistry of New Jersey-New Jersey Medical School, Newark, New Jersey 07103, USA.
authors.forename: John Robert
authors.initials: JR
authors.lastname: Bach
authors.forename: Miguel
authors.initials: M
authors.lastname: Goncalves
mesh_terms: D000328:Adult; D020878:Device Removal; D005260:Female; D006801:Humans; D007327:Insufflation; D007385:Intermittent Positive-Pressure Ventilation; D007442:Intubation, Intratracheal; D008297:Male; D008875:Middle Aged; D020388:Muscular Dystrophy, Duchenne / Q000628:therapy*; D015300:Ventilator Weaning / Q000379:methods*