Nocturnal ventilation in neuromuscular disease--when and how?

While much evidence has been gained over the last decade to support the use of non-invasive ventilation (NIV) in a series of acute and chronic applications, some issues still need to be addressed, particularly regarding the timing of initiation of NIV and the best methods of implementation. This article discusses the role of NIV, if any, in preventing respiratory decline, as a physiotherapy adjunct, and in perioperative care for adults and children with neuromuscular disease.