Intermittent abdominal pressure ventilation management in neuromuscular diseases: a Delphi panel Consensus.

IF 2.9 3区医学 Q2 RESPIRATORY SYSTEM

Expert Review of Respiratory Medicine Pub Date : 2023-01-01 Epub Date: 2023-06-21 DOI:10.1080/17476348.2023.2226391

Anna Annunziata, Paola Pierucci, Paolo Innocente Banfi, Annalisa Carlucci, Antonietta Coppola, Fabrizio Rao, Matteo Schisano, Francesca Simioli, Claudia Crimi, Antonio M Esquinas, Zuhal Karakurt, Alessio Mattei, Antonella Marotta, John R Bach, Giuseppe Fiorentino

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引用次数: 0

Abstract

Background: Intermittent abdominal pressure ventilator (IAPV) use started in the 1930s for ventilatory assistance with muscular dystrophy patients. Later, the device was perfected and expanded for other neuromuscular disorders (NMD). In recent years, the morbidity and mortality tracheotomies and trach tubes related renewed the interest around IAPV. However, there are no guidelines for its use. This study aimed to establish a consensus among physicians involved in its practice to provide IAPV suggestions for the treatment of patients with NMD.

Method: A 3-step modified Delphi method was used to establish consensus. Fourteen respiratory physicians and one psychiatrist with strong experience in IAPV use and/or who published manuscripts on the topic participated in the panel. A systematic review of the literature was carried out according to the PRISMA to identify existing evidence on IAPV for patients with neuromuscular disorders.

Results: In the first round, 34 statements were circulated. Panel members marked 'agree' or 'disagree' for each statement and provided comments. The agreement was reached after the second voting session for all 34 statements.

Conclusions: Panel members agreed and IAPV indications, parameter settings (including procedure protocol), potential limitations, contraindications, complications, monitoring, and follow-up are described. This is the first expert consensus on IAPV.

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神经肌肉疾病的间歇性腹压通气管理：德尔菲小组共识。

背景：间歇性腹压通气机（IAPV）于20世纪30年代开始用于肌营养不良患者的通气辅助。后来，该装置被完善并扩展用于其他神经肌肉疾病（NMD）。近年来，气管切开术和气管插管相关的发病率和死亡率重新引起了人们对IAPV的兴趣。然而，没有关于其使用的指导方针。本研究旨在在参与其实践的医生中建立共识，为NMD患者的治疗提供IAPV建议。方法：采用三步改进德尔菲法建立共识。14名呼吸科医生和一名在IAPV使用方面有丰富经验和/或发表过该主题手稿的精神病学家参加了小组讨论。根据PRISMA对文献进行了系统回顾，以确定神经肌肉疾病患者IAPV的现有证据。结果：在第一轮会议上，分发了34份声明。小组成员对每一项发言都标明“同意”或“不同意”，并提供了意见。该协议是在对所有34项发言进行第二次投票后达成的。结论：小组成员一致同意，并对IAPV适应症、参数设置（包括手术方案）、潜在局限性、禁忌症、并发症、监测和随访进行了描述。这是首次就IAPV达成专家共识。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Expert Review of Respiratory Medicine RESPIRATORY SYSTEM-

CiteScore

6.80

自引率

2.60%

发文量

期刊介绍： Coverage will include the following key areas: - Prospects for new and emerging therapeutics - Epidemiology of disease - Preventive strategies - All aspects of COPD, from patient self-management to systemic effects of the disease and comorbidities - Improved diagnostic methods, including imaging techniques, biomarkers and physiological tests. - Advances in the treatment of respiratory infections and drug resistance issues - Occupational and environmental factors - Progress in smoking intervention and cessation methods - Disease and treatment issues for defined populations, such as children and the elderly - Respiratory intensive and critical care - Updates on the status and advances of specific disease areas, including asthma, HIV/AIDS-related disease, cystic fibrosis, COPD and sleep-disordered breathing morbidity