Mouthpiece Ventilation in Patients with Neuromuscular Disease: A Brief Clinical Review

The Open-circuit Mouthpiece Ventilation (MPV) is a mode of ventilation that uses a mouthpiece interface which the patient holds with the lips when he wants to be supported during inspiration. There exists a poor understanding of this method's benefits compared to other modalities. Non-invasive ventilation (NIV) is sometimes reported as suboptimal in neuromuscular disease patients due to excessive secretions in the airways , hypercapnia due to inadequate ventilator settings , or because of a lack of tolerance of the interface. Interfaces that cover the nose and / or mouth and nose are the most commonly used, but may cause skin lesions and claustrophobia. Many of these drawbacks can be avoided by using a mouthpiece to administer the NIV. The MPV is used by many patients as daytime ventilatory support in combination with other modes of ventilation interface effective for night ventilation. There are two models mouthpiece of different sizes 15 and 22 mm .NIV has been used for years in patients with neuromuscular disorders as a viable alternative to continuous ventilatory support via tracheotomy tube. NIV is associated with a reduced risk of pneumonia and other respiratory complications. Its use in the volumetric mode allows air-stacking to improve cough. The mouthpiece interface facilitates speech and swallowing, factors that lead to a better quality of life for patients. This review aims to highlight the indications, along with the advantages and disadvantages of MPV.