[From poliomyelitis to myopathies: management of respiratory insufficiency in neuromuscular disease].

Chronic respiratory insufficiency by neuromuscular disease is a problem with unknown fullness. Thirty eight patients were followed in a specialized center and have been treated by several means: Intermittent positive pressure breathing was employed for 6 patients with a vital capacity which was between 30 and 50% of normal values. It prevents thoracic deformation and aggravation of restrictive syndrome. It was used for preventive effect. Endotracheal ventilation by tracheostomy (13 cases) is an invasive but necessary method which was employed when there were obstructive bronchial secretions and very deep respiratory insufficiency (vital capacity under 30%). Ventilation by extra thoracic prosthesis was used in eighteen patients. Body ventilator, wrap, pneumo-belt were chosen in function of abdominothoracic morphology. "Personalized" nasal mask ventilation is a great interest non invasive method. It was applied in one case (myopathy with sleep apnea syndrome).