MND-RESPIRATORY FAILURE

SUMMARY

1. Monitor respiratory function: look for symptoms of respiratory failure.
2. Monitor respiratory function tests: pCO₂ > 45 mmHg, FVC < 50% predicted, MIP < 60 cm H₂O, SNIP < 40 cm H₂O, nocturnal desaturation.

3. Non-invasive BiPAP: provides symptom relief (fatigue, breathlessness, improved sleep), prolongs life (Berlowitz 2016). Consider: cost, tolerance, caregiver dependence.

4. Avoid supplemental O₂ as this is type 2 RF.

Reference(s)

Wilkinson, I., Furmedge, D. and Sinharay, R. (2017). Oxford handbook of clinical medicine. Oxford: Oxford University Press. Get it on Amazon.
Feather, A., Randall, D. and Waterhouse, M. (2020). Kumar And Clark’s Clinical Medicine. 10th ed. S.L.: Elsevier Health Sciences. Get it on Amazon.
Hannaman, R. A., Bullock, L., Hatchell, C. A., & Yoffe, M. (2016). Internal medicine review core curriculum, 2017-2018. CO Springs, CO: MedStudy.
Therapeutic Guidelines. Melbourne: Therapeutic Guidelines Limited. https://www.tg.org.au [Accessed 2021].