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Mouthpiece ventilation in Duchenne muscular dystrophy: a rescue strategy for noncompliant patients

Overview of attention for article published in Jornal Brasileiro de Pneumologia, December 2016
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Mouthpiece ventilation in Duchenne muscular dystrophy: a rescue strategy for noncompliant patients
Published in
Jornal Brasileiro de Pneumologia, December 2016
DOI 10.1590/s1806-37562016000000050
Pubmed ID

Fiorentino, Giuseppe, Annunziata, Anna, Cauteruccio, Rosa, Frega, Gianfranco Scotto di, Esquinas, Antonio, Giuseppe Fiorentino, Anna Annunziata, Rosa Cauteruccio, Gianfranco Scotto di Frega, Antonio Esquinas


To evaluate mouthpiece ventilation (MPV) in patients with Duchenne muscular dystrophy (DMD) who are noncompliant with noninvasive ventilation (NIV). We evaluated four young patients with DMD who had previously refused to undergo NIV. Each patient was reassessed and encouraged to try MPV. The four patients tolerated MPV well and were compliant with NIV at home. MPV proved to be preferable and more comfortable than NIV with any other type of interface. Two of the patients required overnight NIV and eventually agreed to use a nasal mask during the night. The advantages of MPV over other types of NIV include fewer speech problems, better appearance, and less impact on the patient, eliminating the risk of skin breakdown, gastric distension, conjunctivitis, and claustrophobia. The use of a mouthpiece interface should be always considered in patients with DMD who need to start NIV, in order to promote a positive approach and a rapid acceptance of NIV. Using MPV during the daytime makes patients feel safe and more likely to use NIV at night. In addition, MPV increases treatment compliance for those who refuse to use other types of interfaces. Avaliar a ventilação bucal (VB) em pacientes com distrofia muscular de Duchenne (DMD) não aderentes à ventilação não invasiva (VNI). Foram avaliados quatro pacientes jovens com DMD que anteriormente recusaram-se a se submeter à VNI. Cada paciente foi reavaliado e encorajado a tentar VB. Os quatro pacientes toleraram bem a VB e aderiram ao uso de VNI em casa. O uso de VB provou ser uma alternativa preferível e mais confortável que o uso de VNI com qualquer outro tipo de interface. Dois dos pacientes necessitaram de VNI noturna e eventualmente aceitaram utilizar uma máscara nasal durante a noite. As vantagens da VB sobre outros tipos de VNI incluem menores problemas na fala, melhor aparência e menor impacto no paciente, eliminando o risco de lesões na pele, distensão gástrica, conjuntivite e claustrofobia. O uso da interface bucal sempre deve ser considerado em pacientes com DMD que necessitam iniciar VNI a fim de promover uma abordagem positiva e uma rápida aceitação da VNI. O uso diurno de VB faz com que os pacientes sintam-se seguros e mais propensos a utilizar VNI à noite. Além disso, a VB aumenta a adesão ao tratamento naqueles pacientes que se recusam a utilizar outros tipos de interfaces.

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Mendeley readers

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Geographical breakdown

Country Count As %
Unknown 38 100%

Demographic breakdown

Readers by professional status Count As %
Student > Bachelor 5 13%
Student > Master 5 13%
Student > Ph. D. Student 4 11%
Other 2 5%
Student > Postgraduate 2 5%
Other 6 16%
Unknown 14 37%
Readers by discipline Count As %
Medicine and Dentistry 10 26%
Nursing and Health Professions 5 13%
Agricultural and Biological Sciences 2 5%
Biochemistry, Genetics and Molecular Biology 1 3%
Unspecified 1 3%
Other 4 11%
Unknown 15 39%