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Internet facilitated management improves home ventilation in amyotrophic lateral sclerosis
  1. Michael Swash
  1. Correspondence to Professor M Swash, Department of Neurology, The Royal London Hospital, London E1 1BB, UK; mswash{at}btinternet.com

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Intermittent positive pressure ventilation has become increasingly used in patients with type 2 respiratory failure, largely because of non-invasive ventilation (NIV), a practical, effective and safe procedure through technical advances for its use in the home setting.1 2 Successful NIV requires careful monitoring, implying a need for home visits by skilled staff, regular hospital visits and the availability of an emergency backup service at all times. Emergencies mostly relate to blockage of respiratory passages by mucus or infections rather than technical failures. The most difficult phase of NIV is the period of initial adaptation to the ventilator which requires frequent adjustments to the pressure–volume variables. In general, early …

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