[Respiratory muscle aids during an episode of aspiration in a patient with Duchenne muscular dystrophy].
We report the case of a Duchenne muscular dystrophy patient with good bulbar function but severely decreased forced vital capacity (9%) and spontaneous peak cough flow (PCF) (2.35 L/s). The patient needed continuous noninvasive ventilation (NIV) consisting of a volumetric ventilator with a nighttime nasal mask and a daytime mouthpiece. He also required application of manually assisted coughing techniques by insufflation with a resuscitation bag and chest thrust (manually assisted PCF after maximum insufflation capacity of 4.33 L/s). An episode of serious food aspiration was resolved by his main caregiver through NIV and manually assisted coughing. Bronchoscopy under sedation using NIV with a lip seal connection to his volumetric ventilator later revealed that no material remained. This case exemplifies the potential role of skilled respiratory management in some neuromuscular diseases.
Servera
E
E
Servicio de Neumología, Hospital Clínico Universitario de Valencia, Universidad de Valencia, Valencia, Spain. emilio.Servera@uv.es
Sancho
J
J
Franco
J
J
Vergara
P
P
Catalá
A
A
Zafra
M J
MJ
D000328:Adult; D045422:Continuous Positive Airway Pressure; D003371:Cough; D006801:Humans; D001239:Inhalation; D008297:Male; D020388:Muscular Dystrophy, Duchenne / Q000150:complications* / Q000503:physiopathology / Q000534:rehabilitation*; D011015:Pneumonia, Aspiration / Q000209:etiology / Q000517:prevention & control*; D012131:Respiratory Insufficiency / Q000150:complications* / Q000534:rehabilitation*