Use of non-invasive ventilation in Motor Neuron Disease – a retrospective cohort analysis

Title: Use of non-invasive ventilation in Motor Neuron Disease – a retrospective cohort analysis
Author(s): L Walsh K Deasy A Ryan D Murphy
Institution: Cork University Hospital
Poster: Click to view poster
Category: General Respiratory and Sleep
Abstract: Motor neuron disease (MND) is a neurodegenerative disorder which leads to progressive muscle weakness including respiratory muscle function decline. The introduction of non-invasive ventilation (NIV) has been shown to improve quality of life, survival and slow the rate of pulmonary function decline. Better compliance with the machine, using it for greater than 4hours per day has been shown to have the greatest long-term benefit.
A retrospective chart analysis of patients who attended the MND clinic from 2009 -2019 in Cork University Hospital, Ireland, was carried out to evaluate if NIV and greater compliance with NIV improved survival. Information regarding NIV use, compliance, pulmonary function tests (PFTs) and basic patient demographics was collected. In total 111 patients were included in the study.
The mean age at diagnosis was 63.8 years and 61.3% were males. 66.7% of our patient cohort used NIV and 44.1% were compliant. There was a statistically significant longer survival in those who used NIV (p=0.002) and in those who used NIV optimally (p=0.02) when both groups were compared to those who did not use NIV. In the bulbar MND group those who were compliant with NIV survived longer than who those who did not use NIV (p=0.001). Bulbar onset MND had worse SNIP and peak cough flow at diagnosis.
We found a significantly longer survival with the use of NIV, the use of NIV optimally and with use of NIV in those with bulbar onset MND compared to those who did not use NIV but this was not reflected in the limb onset MND group alone.