Respiratory management of patients with neuromuscular weakness: A review based on the CHEST 2023 Guidelines

Abstract

Respiratory management in patients with neuromuscular weakness is crucial to improve quality of life and prevent severe complications. Respiratory muscle weakness affects ventilation and secretion clearance, which can lead to respiratory failure and increased morbidity and mortality. This article reviews the evidence-based recommendations from the 2023 American College of Chest Physicians (CHEST) clinical protocol for the evaluation, monitoring, and treatment of respiratory distress in these patients. The importance of early identification of ventilatory failure, appropriate use of noninvasive ventilation to avoid prolonged intubation, and secretion management to reduce pulmonary infections are emphasized. In addition, periodic assessment of lung function, multidisciplinary management, and personalized ventilatory support based on clinical progression are recommended. The document also highlights the need for individualized plans for the transition to home care and consideration of quality of life in therapeutic decisions. These guidelines seek to standardize the clinical approach to optimize outcomes and reduce complications in this vulnerable population.