Non-invasive ventilation reduces respiratory tract infections in children with neuromuscular disorders

Abstract

Non-invasive ventilation (NIV) has been shown to improve gas exchange and survival in patients with chronic neuromuscular disorders. Little is known about its influence on respiratory tract infections (RTIs). Twenty-four patients with regular use of NIV and 11 patients without NIV with neuromuscular disorders answered a questionnaire concerning the use of NIV and assisted coughing techniques, the status of influenza and pneumococcus vaccination, and the frequency and severity of RTIs. Additionally, we performed a retrospective chart review of twelve patients who were ventilated over a period of at least 5 years. In the first year of NIV consultations of a general practitioner due to RTI decreased from 9.2 ± 20.8 to 3.2 ± 5.3 per year (P < 0.005), the number of antibiotic treatment due to RTI decreased from 4.1 ± 3.4 to 1.9 ± 2.2 per year (P < 0.005) and the number of hospital admissions due to RTI decreased from 1.6 ± 1.7 to 0.7 ± 1.3 per year (P < 0.005). Vaccinations against influenza and/or pneumococcus did not have a significant influence on the rate of infections. In 12 patients using NIV for more than 5 years the incidence of RTI requiring hospital admission decreased from 0.54 ± 0.41/year in the pre-ventilation period to 0.12 ± 0.09/year in the NIV period (P < 0.005). NIV had a favorable impact on respiratory infectious complications in children with neuromuscular disorders. © 2007 Wiley-Liss, Inc.