Practical recommendations for swallowing and speaking during NIV in people with neuromuscular disorders.

Tiina Maarit Andersen, Lee Bolton, Michel Toussaint
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Abstract

Objectives: The functions of eating, drinking, speaking, and breathing demand close coordination of the upper airway musculature which may be challenged by the long-term use of daytime non-invasive ventilation (NIV). This rapid review explores the challenges and practicalities of these interactions in people with neuromuscular disorders.

Methods: A search was performed on PubMed (period 2000-2023) using generic terms to refer to eating, drinking, and speaking related to people with neuromuscular disorders on NIV. A narrative approach was used to summarize the available literature.

Results: Our review shows only a small number of studies exist exploring the use of NIV on swallowing and speaking in people with neuromuscular disorders. We summarize study findings and provide practical advice on eating, drinking and speaking with NIV.

Conclusions: By understanding breathing, NIV mechanics and upper airway interactions, it is possible to optimize swallowing and speaking whilst using NIV. There is a lack of specific guidelines, and concerns regarding aspiration warrant further research and guideline development.

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关于神经肌肉障碍患者在使用 NIV 时吞咽和说话的实用建议。
目标:进食、饮水、说话和呼吸等功能需要上气道肌肉组织的密切配合,而长期使用日间无创通气(NIV)可能会对这些功能造成挑战。这篇快速综述探讨了神经肌肉障碍患者在这些互动中面临的挑战和实际情况:使用通用术语在 PubMed(2000-2023 年)上搜索了与使用 NIV 的神经肌肉障碍患者有关的吃、喝和说话。我们采用叙述的方法对现有文献进行了总结:我们的综述显示,只有少数研究探讨了使用 NIV 对神经肌肉障碍患者吞咽和说话的影响。我们总结了研究结果,并就使用 NIV 进食、饮水和说话提供了实用建议:通过了解呼吸、NIV 机理和上气道相互作用,可以优化使用 NIV 时的吞咽和说话。目前还缺乏具体的指导原则,而有关吸入的问题则需要进一步的研究和指导原则的制定。
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