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. 2018 Jun 15;5(6):78. doi: 10.3390/children5060078

Table 2.

Clinical management recommendations for children with neuromuscular disease (NMD) on the basis of diagnostic test results.

Recommendation Diagnostic Test Results
Initiate cough augmentation device PCF < 270 L/min for children ≥12 years of age
MEP < 60 cmH2O
Perform overnight sleep monitoring FVC < 60% predicted
MIP < 40 cmH2O
Clinical symptoms suggestive of SDB
Loss of ambulation
Children with NMD that will never have the ability to ambulate
Infants with NMD
Initiate nocturnal non-invasive ventilation (DMD specifically) Baseline awake SpO2 < 95%
Baseline awake pCO2 > 45 mmHg
FVC < 30–50% if undergoing a surgical procedure
Evidence of SDB on PSG

SDB—sleep-disordered breathing; DMD—Duchenne muscular dystrophy; PSG—polysomnogram