%0 Journal Article %A David Orlikowski %A Hélène Prigent %A Jésus Gonzalez-Bermejo %A Philippe Aubert %A Frédéric Lofaso %A Jean Claude Raphael %A Bernard Clair %T Noninvasive Ventilation As an Alternative to Endotracheal Intubation During Tracheotomy in Advanced Neuromuscular Disease %D 2007 %J Respiratory Care %P 1728-1733 %V 52 %N 12 %X OBJECTIVE: To compare conventional tracheotomy with endotracheal intubation to tracheotomy with noninvasive positive-pressure ventilation (NPPV) in advanced neuromuscular disease. METHODS: This was a retrospective study of a historical cohort of patients tracheotomized while sedated and intubated versus patients tracheotomized under NPPV and local anesthesia. We recorded previous intubation difficulties, complications (eg, aspiration pneumonia), and hospital stay. RESULTS: Conventional tracheotomy was performed in 7 patients. We performed tracheotomy during NPPV with local anesthesia in 13 patients. All but 3 patients had risk factors for difficult intubation. Hospital stay was 23.3 ± 10.3 d in the conventional group and 25.3 ± 12.9 d in the NPPV group (p = 0.87). The number of pneumonias was higher in the conventional-tracheotomy group (4 vs 1, p = 0.03). CONCLUSION: In neuromuscular patients, performing tracheotomy with NPPV and local anesthesia may help avoid endotracheal intubation and reduce morbidity. %U https://rc.rcjournal.com/content/respcare/52/12/1728.full.pdf