Non-invasive ventilation reduces respiratory tract infections in children with neuromuscular disorders.
Non-invasive ventilation (NIV) has been shown to improve gas exchange and survival in patients with chronic neuromuscular disorders. Little is known about its influence on respiratory tract infections (RTIs). Twenty-four patients with regular use of NIV and 11 patients without NIV with neuromuscular disorders answered a questionnaire concerning the use of NIV and assisted coughing techniques, the status of influenza and pneumococcus vaccination, and the frequency and severity of RTIs. Additionally, we performed a retrospective chart review of twelve patients who were ventilated over a period of at least 5 years. In the first year of NIV consultations of a general practitioner due to RTI decreased from 9.2+/-20.8 to 3.2+/-5.3 per year (P<0.005), the number of antibiotic treatment due to RTI decreased from 4.1+/-3.4 to 1.9+/-2.2 per year (P<0.005) and the number of hospital admissions due to RTI decreased from 1.6+/-1.7 to 0.7+/-1.3 per year (P<0.005). Vaccinations against influenza and/or pneumococcus did not have a significant influence on the rate of infections. In 12 patients using NIV for more than 5 years the incidence of RTI requiring hospital admission decreased from 0.54+/-0.41/year in the pre-ventilation period to 0.12+/-0.09/year in the NIV period (P<0.005). NIV had a favorable impact on respiratory infectious complications in children with neuromuscular disorders.
Dohna-Schwake
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Department of Pediatrics and Pediatric Neurology, University of Essen, Essen, Germany. christian.schwake@uni-essen.de
Podlewski
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Voit
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T
Mellies
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D000293:Adolescent; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002648:Child; D011307:Drug Prescriptions / Q000706:statistics & numerical data; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D007252:Influenza Vaccines / Q000627:therapeutic use; D009468:Neuromuscular Diseases / Q000503:physiopathology* / Q000628:therapy*; D010821:Physicians, Family / Q000706:statistics & numerical data; D022242:Pneumococcal Vaccines / Q000627:therapeutic use; D011175:Positive-Pressure Respiration / Q000706:statistics & numerical data*; D012132:Respiratory Muscles / Q000503:physiopathology; D012141:Respiratory Tract Infections / Q000188:drug therapy / Q000453:epidemiology* / Q000517:prevention & control; D012189:Retrospective Studies; D011795:Surveys and Questionnaires; D016896:Treatment Outcome
D000900:Anti-Bacterial Agents; D007252:Influenza Vaccines; D022242:Pneumococcal Vaccines