Non-invasive ventilation in motor neuron disease/amyotrophic lateral sclerosis: an Australian perspective

There is a paucity in Australian literature regarding the current practice trends in the use of non-invasive ventilation therapy in patients with motor neuron disease/ amyotrophic lateral sclerosis (MND). The issue of whether non-invasive ventilation support should be provided to patients with irreversible neurodegenerative disease remains debated by some clinicians. An understanding of the practices of Australian and New Zealand specialists with respects to non-invasive ventilation (NIV) in motor neuron disease is thus important. This study reports the findings of a questionnaire study conducted in Australia and New Zealand via the memberships of the Thoracic Society of Australia and New Zealand, and The Australia and New Zealand Association of Neurologists. It aimed to gain insight into the respiratory and neurologist specialists’ current practice and preferences in non-invasive ventilation therapy (NIV) for Motor Neuron Disease (MND) patients. In this study, the rate of NIV therapy use in MND patients by the respiratory physicians and neurologists was 75% and 29% respectively. Sixty percent of neurologists referred symptomatic MND patients to either a respiratory physician or to MND multidisciplinary clinic. There was high variability in the manner patients were assessed as needing NIV therapy, as there was in how patients were monitored on treatment.