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. 2016 Oct 17;17(10):1735. doi: 10.3390/ijms17101735

Table 2.

General indications and contraindications for the initiation of long-term positive pressure ventilation in patients with neuromuscular disease [26]. FVC, forced vital capacity; MIP, maximal inspiratory pressure; SDB, sleep-disordered breathing; paCO2, partial pressure of carbon dioxide; RMW, respiratory muscle weakness; saO2, oxygen saturation; tcCO2, transcutaneous carbon dioxide tension; TIV, tracheostomy invasive ventilation.

Mode Non-Invasive Ventilation (NIV) Invasive Ventilation (IV/TIV)
Indications

  • Symptoms of SDB or significant inspiratory muscle weakness

  • Failure of NIV

  • Persistent NIV intolerance

  • Contraindications to NIV

  • NIV > 20 h/day (consider)

  • Acute respiratory compromise
and at least one of the following:

  • Daytime hypercapnia (paCO2 ≥45 mmHg)

  • Nocturnal hypercapnia (paCO2/tcCO2 > 50 mmHg)

  • Nocturnal oxygen desaturation (SaO2) < 90% for at least five Consecutive minutes

  • Overnight increase of pCO2/tcCO2 > 10 mmHg from baseline

  • FVC < 50% predicted

  • MIP < 60 cm H2O (if rapid deterioration of RMW is present)

Contraindications Relative

  • Inadequate caregiver support

  • Severe dysphagia

  • Inadequate caregiver support

  • Initial need for full-time ventilation

Absolute

  • Persistent upper airway obstruction

  • Persistent hypersecretion

  • Inability to co-operate

  • Inefficient cough (even with assistance)