Respiratory assistance should be started at night with a ventilator through a nasal mask and later, when needed, daytime ventilation using a mouthpiece can be added. In the earlier stages, nocturnal ventilation is sufficient to eliminate symptoms of underventilation. Preventive ventilation before symptoms occur is not effective. Tracheostomy ventilation is indicated when patients have little respiratory autonomy and show poor results of non-invasive ventilation or when swallowing disorders lead to chronic aspiration of saliva and food. Tracheostomy is very effective, but it is not usually reversible and increases drastically the dependency on care that might not be available in every case.
Long term follow up in patients with severe chronic respiratory insufficiency.
Common allergies include dust mites, molds, furry pets. In-ExsufflatorR alternates positive and negative pressure through a mask. Bach has reported successful long-term use. Raphael, JC et al. Survey of patients using vents and their families.