• John Robert Bach and Miguel Goncalves.
• Department of Physical Medicine and Rehabilitation, University of Medicine and Dentistry of New Jersey-New Jersey Medical School, Newark, New Jersey 07103, USA.
• Am J Phys Med Rehabil. 2004 Jul 1;83(7):560-8.

AbstractThis case series of ventilator-dependent patients with neuromuscular disease who had no ventilator-free breathing ability demonstrates that decannulation and switching to continuous noninvasive intermittent positive-pressure ventilation combined with regular lung expansion therapy can result in improvements in pulmonary function and at least partial ventilator weaning. These six patients were also managed using mechanical insufflation-exsufflation for regular lung expansion and cough assistance. Thus, some ventilator users with neuromuscular disease can benefit from tracheostomy tube decannulation and transition to noninvasive intermittent positive-pressure ventilation and assisted coughing for ventilator weaning to predominantly nocturnal-only use.

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