[Non invasive ventilation in the ICU for the neuromuscular patient: ethical issues].
Non-invasive mechanical ventilation in patients with chronic neuromuscular disorders is an effective tool for treating dyspnea or sleep disturbances often observed in such patients. So, NIV has to be considered as a palliative treatment and it must systematically be offered to these patients. Mechanical ventilation, non-invasive or invasive (via a trachesotomy) have to be considered systematically with patients and families at an earlier stages of these diseases in order to design a strategy in case of acute respiratory failure. In a second parent paper of this issue, we discuss the medico-legal implications of mechanical ventilation in neuromuscular failure, particularly the end-of-life aspects.
Service des soins intensifs, HUG, 1211 Genève 14.
Jean-Claude
JC
Chevrolet
Jean-Paul
JP
Janssens
Dan
D
Adler
D000690:Amyotrophic Lateral Sclerosis / Q000628:therapy; D006801:Humans; D020388:Muscular Dystrophy, Duchenne / Q000628:therapy; D009468:Neuromuscular Diseases / Q000150:complications / Q000628:therapy*; D010166:Palliative Care / Q000941:ethics* / Q000331:legislation & jurisprudence; D011175:Positive-Pressure Respiration / Q000941:ethics*; D011788:Quality of Life; D012121:Respiration, Artificial / Q000941:ethics; D012131:Respiratory Insufficiency / Q000209:etiology / Q000628:therapy*; D013557:Switzerland; D014139:Tracheostomy / Q000941:ethics* / Q000331:legislation & jurisprudence