Getting NIV right for the patient

02 December 2006

Recent research has proved that non-invasive ventilation (NIV) can improve the quality of life and the length of survival for many people with Motor Neurone Disease.

But this therapy does not suit all patients, and some discontinue the treatment because they do not like its side-effects. In addition, it may be difficult for professionals to identify when to start the treatment for maximum effectiveness.

The issues surrounding the best use of NIV as part of a “gold standard” respiratory management care package were explored on the final day of the 17th International Symposium on ALS/MND in Yokohama.

Presenters talked about the need to tailor NIV to the individual patient, such as choosing the right mask, and to support them in becoming accustomed to the treatment over short periods before building up to through-the-night or continual usage.

Hannah Nixon, representing her colleagues at the University of Sheffield research group led by Professor Pamela Shaw, presented findings on the most common problems people had using NIV. These ranged from dryness and secretions to chest infections, pressure sores and anxiety about wearing the mask.

She showed evidence that cough assist machines can help clear secretions and prevent chest infection, and should therefore be considered to accompany NIV within a respiratory management care package.

Ms Nixon said it was also important to look at NIV and end of life, and to educate health and social care professionals and families about this. She said: “It’s important for families to know that NIV can be removed at any time to enhance patient comfort when they are close to death.”

Delegates also heard about research to find the best way to measure respiratory function, to help professionals know when NIV is appropriate. Tests featured ranged from measuring SNIP (sniff nasal inspiratory pressure) or MIP (maximal inspiratory pressure) to a non-invasive test that can detect CO2 levels in a patient’s blood.

Also in this session, encouraging preliminary results were presented from studies into using pacemakers to stimulate the diaphragm and the phrenic nerve. This may be a way of preserving respiratory function, and delaying the need for NIV.

Sarah Fitzgerald Head of PR and Media
01604 611840
sarah.fitzgerald@mndassociation.org

The 17th International Symposium on ALS/MND is taking place in Yokohama, Japan, between Thursday, 30 November and Saturday, 2 December. The event is organised by the UK-based Motor Neurone Disease (MND) Association and hosted this year by the Japanese ALS Association (JALSA).