title: American College of Chest Physicians consensus statement on the respiratory and related management of patients with Duchenne muscular dystrophy undergoing anesthesia or sedation.
abstract: This statement on the management of patients with Duchenne muscular dystrophy (DMD) undergoing procedural sedation or general anesthesia represents the consensus opinion of a multidisciplinary panel convened under the auspices of the American College of Chest Physicians. Expert recommendations on this subject are needed for several reasons. First, patients with DMD have an increased risk of complications when they undergo sedation or general anesthesia. In addition, due to improved cardiopulmonary therapies, patients with DMD are experiencing an unprecedented duration of survival. As a result, it is more common for them to require procedures involving sedation or general anesthesia. The risks related to anesthesia and sedation for DMD patients include potentially fatal reactions to inhaled anesthetics and certain muscle relaxants, upper airway obstruction, hypoventilation, atelectasis, congestive heart failure, cardiac dysrhythmias, respiratory failure, and difficulty weaning from mechanical ventilation. This statement includes advice regarding the highly interrelated areas of respiratory, cardiac, GI, and anesthetic management of patients with DMD undergoing general anesthesia or procedural sedation. The statement is intended to aid clinicians involved in the care of patients with DMD and to be a resource for other stakeholders in this field, including patients and their families. It is an up-to-date summary of medical literature regarding this topic and identifies areas in need of future research.
authors: Department of Pediatrics, MetroHealth Medical Center, Case Western Reserve University, 2500 MetroHealth Dr, Cleveland, OH 44109-1900, USA. dbirnkrant@metrohealth.org
authors: David J
authors: DJ
authors: Birnkrant
authors: Howard B
authors: HB
authors: Panitch
authors: Joshua O
authors: JO
authors: Benditt
authors: Louis J
authors: LJ
authors: Boitano
authors: Edward R
authors: ER
authors: Carter
authors: Valerie A
authors: VA
authors: Cwik
authors: Jonathan D
authors: JD
authors: Finder
authors: Susan T
authors: ST
authors: Iannaccone
authors: Lawrence E
authors: LE
authors: Jacobson
authors: Gary L
authors: GL
authors: Kohn
authors: Etsuro K
authors: EK
authors: Motoyama
authors: Richard T
authors: RT
authors: Moxley
authors: Mary K
authors: MK
authors: Schroth
authors: Girish D
authors: GD
authors: Sharma
authors: Michael D
authors: MD
authors: Sussman
mesh_terms: D000768:Anesthesia, General / Q000009:adverse effects / Q000592:standards*; D016292:Procedural Sedation / Q000009:adverse effects / Q000592:standards*; D006801:Humans; D020388:Muscular Dystrophy, Duchenne / Q000150:complications* / Q000503:physiopathology; D012121:Respiration, Artificial / Q000592:standards*; D012307:Risk Factors