A significant number of neuromuscular patients with severe respiratory impairment are ventilated invasively, most often by means of a tracheostomy. An international study compiled data from 19 centers offering an alternative ventilation mode based on the continuous use of non-invasive ventilation coupled with insufflation-exsufflation maneuvers:
- the data, directly collected from the centers or through their publications, only concerned patients with amyotrophic lateral sclerosis (ALS), Duchenne muscular dystrophy (DMD) or type 1 spinal muscular atrophy (SMA1);
- this alternative technique is reliable and quite feasible, including in elderly patients with SMA1;
- it finds its limits in damage to the first motor neuron, in this case in ALS.
