Pulmonary Neuromuscular and Assisted Ventilation
We provide specialized care for patients with respiratory muscle weakness and other conditions that lead to chronic respiratory failure and/or hypoventilation (shallow breathing).
Our specialists provide comprehensive pulmonary care for patients with:
- Neuromuscular conditions such as muscular dystrophies, myopathies and ALS
- Chest wall diseases such as kyphoscoliosis
- Diaphragm paralysis
Multidisciplinary Care
Experts at our Adult Neuromuscular Clinic and the Amyotrophic Lateral Sclerosis (ALS) Clinic work closely with us to treat many of these patients.
Our specialists also provide consultations for chronic respiratory failure and/or hypoventilation in patients with other diseases, such as:
- Congenital hypoventilation
- Hypercapnic (severe) COPD
- Obesity hypoventilation syndrome
- Opioid-related sleep apnea
Testing and Assessments
Lung function testing: We collaborate with our Pulmonary Function Laboratory to perform comprehensive lung function testing, along with more specialized tests to assess respiratory and diaphragm muscle strength and cough effectiveness. These tests may not be widely available elsewhere.
Sleep studies: For select patients, overnight sleep studies can help us diagnose breathing issues. A sleep study also can be used to adjust nocturnal, non-invasive ventilation settings. Studies are performed at the UC San Diego Health Sleep Center, which uses state-of-the-art testing, including specialized measures such as transcutaneous carbon dioxide monitoring.
Imaging: For certain patients, advanced lung and diaphragm imaging are used during the assessment.
Treatments
Non-invasive ventilation: Also known as BiPap, nocturnal non-invasive ventilation can help support weak respiratory muscles and increase airflow. We have expertise in the latest technologies to ensure the best outcomes possible.
If nocturnal-only treatment is insufficient, we can provide daytime breathing support. All of our patients are followed with remote (cloud) monitoring technology, which allows for ongoing adjustments and optimization.
Tracheostomy ventilation: These days, most patients can be supported with non-invasive ventilation. Patients with tracheostomy are evaluated for a switch to non-invasive therapy, but for patients requiring ventilation with a tracheostomy, we aim to optimize therapy and address issues such as speech and swallowing.
Airway clearance therapies: Neuromuscular patients often have a weak cough, which can be helped with proper airway clearance therapy such as mechanical insufflation-exsufflation.
Respiratory therapy: Our clinic includes a respiratory therapist who performs assessment, teaching and troubleshooting during clinic sessions. In addition, the respiratory therapist can help coordinate with external durable medical equipment (DME) companies to ensure the best possible care at home.