The use of noninvasive respiratory muscle aids in the management of patients with progressive neuromuscular diseases.

Most patients with primarily ventilation impairment can use noninvasive alternatives to tracheostomy for long-term ventilatory support and airway secretion management. The most important and versatile method of noninvasive ventilatory support is mouthpiece intermittent positive pressure ventilation. Mouthpiece intermittent positive pressure ventilation also can be used via a Lipseal for nocturnal support. The intermittent abdominal pressure ventilator is an option for daytime aid, and nasal intermittent positive pressure ventilation is usually preferred for nocturnal support. Manually assisted coughing and mechanical insufflation-exsufflation can be critical for airway secretion elimination.