The Center for Noninvasive Mechanical Ventilation Alternatives
and Pulmonary Rehabilitation

The Center for Noninvasive Mechanical Ventilation Alternatives and Pulmonary Rehabilitation was established in 1992. In consists of physicians and other health care professionals dedicated to the care of patients with neuromuscular weakness and respiratory impairment from any cause.

The center's physicians have:

• Developed orthopedic approaches that prevent musculotendinous contractures and prolong brace-free ambulation.
• Developed inspiratory and expiratory muscle aids that prevent respiratory complications of neuromuscular weakness.
• Described a cardiac management protocol that has reversed the cardiac stress associated with the cardiomyopathy of myopathic disease.
• Developed approaches that avoid the use of general anesthesia (Dr. Colin Bethyl, Dr. Ken Swan)

And, with the use of inspiratory and expiratory muscle aids, they perform surgery on patients with little or no respiratory muscle function with minimal risk of respiratory complications and no need to resort to tracheostomy.

The center's anesthesiologists and intensive care physicians (Drs. Baird, Navado, Katz, Davidson, Gbayismore) permit patients to undergo general anesthesia or require intensive care with little of any risk of prolonged respiratory failure or need to resort to tracheostomy. This is in large part because noninvasive inspiratory and expiratory aids like the Cough-Assist are used in all of the hospital's intensive care units by its specifically trained and skilled respiratory therapists and nurses.

The center has removed over 100 tracheostomy tubes from ventilator users with absolutely no ability to breathe and taught many of them, even those with little or no respiratory muscle function, how to breathe without ventilators.

John R. Bach MD

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