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Mechanical Ventilation of the Patient with Neuromuscular Disease Dean Hess PhD RRT Associate Professor of Anesthesia, Harvard Medical School Assistant Director of Respiratory Care, Massachusetts General Hospital Editor in Chief, Respiratory Care
Neuromuscular Diseases Causing Respiratory Failure ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Primary NMD Causing Acute Respiratory Failure Mehta, Respir Care 2006; 51:1016
[object Object],[object Object],[object Object],[object Object],[object Object],ICU-Acquired Muscle Weakness
Mobility in the ICU Needham, JAMA 2008 Bailey, Crit Care Med 2007; 35:139 Morris, Crit Care Med 2008; 36:2238 Schweikert, Lancet 2009; 373: 1874 Burtin Crit Care Med 2009; 37:2499
Neuromuscular Respiratory Failure Benditt, Respir Care 2006; 51:829
Respiratory Muscle Training ,[object Object],[object Object]
Cough Assist Techniques ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Noninvasive Ventilation
NIV and ALS patients with normal or moderately impaired bulbar function patients with severe bulbar impairment Bourke, Lancet Neurol 2006;5:140
NIV and ALS: Quality of Life patients with normal or moderately impaired bulbar function patients with severe bulbar impairment Bourke, Lancet Neurol 2006;5:140
Indications for Chronic NIV ,[object Object],[object Object],[object Object],[object Object],Chest 1999; 116: 521–534
 
Respir Care 2006; 51:1005
How to Choose Settings for NIV ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
NIV Settings for NMD ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
NIV Settings for NMD ,[object Object],[object Object],[object Object],[object Object]
Approaches to Intolerance: Chronic Use ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Indications for Tracheostomy ,[object Object],[object Object],[object Object],[object Object],[object Object]
Ventilator Settings for Trach Patient ,[object Object],[object Object],[object Object],[object Object]
Ventilator Settings for Trach Patient ,[object Object],[object Object],[object Object],[object Object]
Effect of PaCO 2  on CBF  20 40 60 P aCO 2  (mm Hg)
Effect of PO 2  on CBF P aO 2  (mm Hg) 0   60   120 100 50
Effect of PCO 2  and PCO 2  on CBF
Hyperventilation in Acute Brain Injury ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Monitoring Brain Oxygenation ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
   FIO 2  to    PbrO 2 ?  ,[object Object],[object Object],[object Object],[object Object],[object Object]
ALI/ARDS in Acute Brain Injury ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Crit Care Med 2007; 35:1815
Does  Level of consciousness  Predict Extubation Success? ,[object Object],[object Object],[object Object],[object Object],[object Object],Namen et al, ARCCM 2001
Does  Level of Consciousness  Predict Extubation Success? ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Coplin et al, AJRCCM 2000
Crit Care Med 2008; 36:2986
Summary ,[object Object],[object Object],[object Object],[object Object],[object Object]

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Neuromuscular Disease

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