title: Outcome of noninvasive ventilation in children with neuromuscular disease.
abstract: OBJECTIVE
  To assess the effect of institution of noninvasive ventilation (NIV) on clinical outcome and quality of life (QOL) in a cohort of children with severe neuromuscular disorders.
  
  
  METHODS
  We reviewed records and obtained clinical data from the year prior to commencing NIV and annually thereafter. Data obtained included diagnosis, patient symptoms, mortality, NIV adverse effects, pulmonary function tests, polysomnographic data, length of hospitalizations, and health care costs. Patients and parents completed questionnaires assessing QOL with NIV and recalling QOL before NIV.
  
  
  RESULTS
  Fourteen of 17 (82%) suitable patients were enrolled. Follow-up ranged from 6 to 84 months (median 30). Symptoms of daytime sleepiness (p = 0.003) and headache (p = 0.046) improved after initiation of NIV. Sleep quality assessed by polysomnography also improved. Hospitalization rates (p = 0.002) and health care costs (p = 0.003) decreased. QOL remained stable after NIV, despite disease progression.
  
  
  CONCLUSIONS
  Treatment of respiratory failure, in children with neuromuscular disease, with noninvasive ventilation results in a reduction in symptoms, hospitalizations, and health care costs without adverse effects on quality of life.
authors.affiliation: Institute for Neuromuscular Research, The Children's Hospital at Westmead, Westmead, Australia.
authors.forename: H K
authors.initials: HK
authors.lastname: Young
authors.forename: A
authors.initials: A
authors.lastname: Lowe
authors.forename: D A
authors.initials: DA
authors.lastname: Fitzgerald
authors.forename: C
authors.initials: C
authors.lastname: Seton
authors.forename: K A
authors.initials: KA
authors.lastname: Waters
authors.forename: E
authors.initials: E
authors.lastname: Kenny
authors.forename: L S
authors.initials: LS
authors.lastname: Hynan
authors.forename: S T
authors.initials: ST
authors.lastname: Iannaccone
authors.forename: K N
authors.initials: KN
authors.lastname: North
authors.forename: M M
authors.initials: MM
authors.lastname: Ryan
mesh_terms: D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D008297:Male; D009468:Neuromuscular Diseases / Q000150:complications / Q000175:diagnosis / Q000628:therapy*; D017063:Outcome Assessment, Health Care; D011788:Quality of Life; D012121:Respiration, Artificial / Q000379:methods*; D012893:Sleep Wake Disorders / Q000175:diagnosis / Q000209:etiology / Q000517:prevention & control*; D016896:Treatment Outcome