CHEST releases clinical practice guideline on respiratory management of patients with neuromuscular weakness

The guideline includes the following highlighted recommendations:

• For patients with neuromuscular diseases (NMD) and chronic respiratory failure, we recommend using noninvasive ventilation (NIV) for treatment. (Strong recommendation)

• For patients with NMD requiring NIV, we suggest individualizing NIV treatment to achieve ventilation goals. (Conditional recommendation)

• For patients with NMD at risk for respiratory failure, we suggest pulmonary function testing at a minimum of every 6 months as appropriate to the course of the specific NMD. (Conditional recommendation)

• For patients with NMD and sialorrhea, we suggest a therapeutic trial of an anticholinergic medication as firstline therapy with continued use only if there are perceived benefits compared with side effects. (Conditional recommendation)

Each recommendation is classified as strong, referred to as “recommended,” or conditional, referred to as “suggested.” The panel offers graded recommendations when there is sufficient evidence and ungraded consensus-based statements in areas that were thought to warrant guidance, despite an insufficient grade of evidence.

Reference:

Akram Khan, Lindsy Frazer-Green, Reshma Amin, Lisa Wolfe, Garner Faulkner, Kenneth Casey, Girish Sharma, Bernardo Selim, David Zielinski, Loutfi S. Aboussouan, Douglas McKim, Peter Gay, Published:March 13, 2023 DOI:https://doi.org/10.1016/j.chest.2023.03.011