April 25, 2007

Life May Get Better With NIV

Noninvasive ventilation (NIV), defined in this study as delivery of air under pressure by facial or nasal mask, allowed for a stabilization in quality of life and improvement in symptoms related to poor breathing in 14 Australian children with neuromuscular disorders.

Monique Ryan at Royal Children’s Hospital in Parkville, Victoria (Australia), and colleagues analyzed questionnaires filled out by parents of children who began using NIV through Children’s Hospital at Westmead (Australia) between 1994 and 2004.

They found that when parents compared life before and after starting NIV, they reported that quality of life stopped deteriorating; that use of NIV by the children didn’t put any additional restrictions on the family; and that most of the children considered their emotional and social well-being to be good.

After starting NIV, there were fewer parents reporting children’s headaches, sleepiness, lack of appetite, swallowing difficulties or attention problems. The number reporting coughing and learning problems remained the same.

The authors, including Susan Iannaccone, MDA clinic director at Children’s Medical Center of Dallas, published their findings in the Jan. 16 issue of Neurology.

In addition to their encouraging findings, they expressed several caveats, noting that current methods of detecting respiratory insufficiency in children with neuromuscular disease may not be adequate; that NIV doesn’t necessarily improve nutritional status; and that NIV should be offered before an emergency arises.