The standard treatment for patients with neuromuscular respiratory failure is non-invasive ventilation (NIV) as non-invasive ventilation support-setting (NVS). NVS is administered through a nasal or face mask and/or mouthpiece with the potential to cause nasal ulcers, discomfort, resulting in poor compliance.

Intermittent abdominal pressure ventilation (IAPV) is a positive pressure ventilation technique that works with abdominal compressions. It has been known since 1938; however, for many years, it was out of production. In recent years, a new device has been produced that has captured the attention to this old respiratory support technique. IAPV was proposed as an alternative to NIV to our patients affected by neuromuscular disease.

We considered fourteen patients with respiratory failure secondary to a neuromuscular disease (4 Steinert disease, 4 Duchenne dystrophy, and 6 Amyotrophic Lateral Sclerosis) intolerant to daytime NIV.  We performed comparison of gas exchange and respiratory parameters at baseline after 60? without ventilation in spontaneous breathing and after 1 hour during IAPV. Furthermore, we evaluated survival, adherence to IAPV and quality of life (QoL) after one year. 
All patients, two years later, are still using intermittent abdominal ventilation.

Conclusion: Intermittent positive abdominal mechanical ventilation can be a valid alternative to noninvasive mechanical ventilation with a nasal or face mask. It improves gas exchange, symptoms, and quality of life, decreases the incidence of pneumonia, and can avert the need for intubation and tracheotomy.