PT  - JOURNAL ARTICLE
AU  - Felicity Dewhurst
AU  - Joanna Elverson
AU  - Amanda Mccleery
AU  - Jolene Brown
AU  - Robert McConnell
AU  - Owen Lever
AU  - Thomas Doris
AU  - Ben Messer
AU  - Andrew Hughes
TI  - Ventilator dependence complications in motor neuron disease
AID  - 10.1136/bmjspcare-2020-002560
DP  - 2020 Sep 21
TA  - BMJ Supportive & Palliative Care
PG  - bmjspcare-2020-002560
4099  - http://spcare.bmj.com/content/early/2020/09/20/bmjspcare-2020-002560.short
4100  - http://spcare.bmj.com/content/early/2020/09/20/bmjspcare-2020-002560.full
AB  - Long-term dependence on non-invasive ventilation (NIV) without time for advance care planning can result in significant complications that may require innovative management strategies. We present the case of a man who was admitted with respiratory failure and required NIV. Despite effective treatment for community acquired pneumonia, attempts to wean NIV failed. While dependent on NIV, a diagnosis of motor neuron disease was made. Time without ventilation was not tolerated and consequently complications of: facial pressure ulceration, nasal septal prolapse, inspissated secretions and failure to feed occurred. This case illustrates the severity of complications that can result from NIV dependence; however, it also details how these can be effectively managed by the hospice multidisciplinary team, with support from experts both within and external to the hospice enabling the acquisition of appropriate skills and knowledge.