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Respiratory management of motor neurone disease: a review of current practice and new developments
  1. Muhammad Khizar Rafiq,
  2. Alison Ruth Proctor,
  3. Christopher J McDermott,
  4. Pamela J Shaw
  1. Academic Neurology Unit, Sheffield Institute for Translational Neuroscience, University of Sheffield, Sheffield, UK
  1. Correspondence to Dr Muhammad Khizar Rafiq, University of Sheffield, Academic Neurology Unit, 385a Glossop Road, Sheffield, South Yorkshire S10 2HQ, UK; m.k.rafiq{at}


Motor neurone disease is a neurodegenerative condition with a significant morbidity and shortened life expectancy. Hypoventilatory respiratory failure is the most common cause of death and respiratory function significantly predicts both survival and quality of life in patients with motor neurone disease. Accordingly, supporting and maintaining respiratory function is important in caring for these patients. The most significant advance in motor neurone disease care of recent years has been the domiciliary provision of non-invasive ventilation for treating respiratory failure. Neuromuscular respiratory weakness also leads to ineffective cough and retained airways secretions, predisposing to recurrent chest infections. In this review, we discuss current practice and recent developments in the respiratory management of motor neurone disease, in terms of ventilatory support and cough augmentation.

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  • Funding This work is supported by the Wellcome Trust, the Motor Neurone Disease Association and the National Institute for Health Research.

  • Competing interests None.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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