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Aylin Oszancak, MD; Nicholas S. Hill, MD
Author and Funding Information

Tufts Medical Center Boston, MA

Correspondence to: Nicholas S. Hill, MD, FCCP, Tufts Medical Center, Boston, MA

The authors have no conflicts of interest to disclose.

Reproduction of this article is prohibited without written permission from the American College of Chest Physicians (www.chestjournal.org/misc/reprints.shtml).


The authors have no conflicts of interest to disclose.

The authors have no conflicts of interest to disclose.

Reproduction of this article is prohibited without written permission from the American College of Chest Physicians (www.chestjournal.org/misc/reprints.shtml).

Reproduction of this article is prohibited without written permission from the American College of Chest Physicians (www.chestjournal.org/misc/reprints.shtml).


Chest. 2009;135(1):247. doi:10.1378/chest.08-2302
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To the Editor:

We appreciate the comments of Drs. Cheng and Bach on our review1 of nocturnal noninvasive ventilation. We are well aware of the successful application of continuous noninvasive ventilation to selected patients with neuromuscular disease,2 as well as the writers' extensive published experience on these techniques.3,4 However, our review focused on nocturnal applications of noninvasive ventilation, and a discussion of continuous use was beyond our scope. Also, we agree that the mouthpiece interface has a role in management of noninvasive ventilation, but space limitations precluded our discussing it because it plays a much smaller role in providing noninvasive ventilation during sleep than nasal or full face masks. Finally, we advocate the use of manually or mechanically assisted coughing methods for patients with weakened cough. We briefly discussed this in our review and referred to the work of Bach.4

Ozsancak A, D'Ambrosio C, Hill NS. Nocturnal noninvasive ventilation. Chest. 2008;133:1275-1286. [PubMed] [CrossRef]
 
Mehta S, Hill NS. Noninvasive ventilation. Am J Respir Crit Care Med. 2001;163:540-577. [PubMed]
 
Bach JR, Alba AS. Noninvasive options for ventilatory support of the traumatic high level quadraplegic. Chest. 1990;98:613-619. [PubMed] [CrossRef]
 
Bach JR. A comparison of long-term ventilatory support alternatives from the perspective of the patient and care giver. Chest. 1993;104:1702-1706. [PubMed] [CrossRef]
 
Bach JR, Goncalves M. Ventilator weaning by lung expansion and decannulation. Am J Phys Med Rehabil. 2004;83:560-568. [PubMed] [CrossRef]
 

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References

Ozsancak A, D'Ambrosio C, Hill NS. Nocturnal noninvasive ventilation. Chest. 2008;133:1275-1286. [PubMed] [CrossRef]
 
Mehta S, Hill NS. Noninvasive ventilation. Am J Respir Crit Care Med. 2001;163:540-577. [PubMed]
 
Bach JR, Alba AS. Noninvasive options for ventilatory support of the traumatic high level quadraplegic. Chest. 1990;98:613-619. [PubMed] [CrossRef]
 
Bach JR. A comparison of long-term ventilatory support alternatives from the perspective of the patient and care giver. Chest. 1993;104:1702-1706. [PubMed] [CrossRef]
 
Bach JR, Goncalves M. Ventilator weaning by lung expansion and decannulation. Am J Phys Med Rehabil. 2004;83:560-568. [PubMed] [CrossRef]
 
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