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Inspiratory Muscle Training as an Adjunct to the Treatment of Weaning Failure in Critically Ill Patients: A Practical Guide
Published on: January 30, 2026
Shared decision-making about prolonged invasive ventilation for adults with myotonic dystrophy type 1
Jalal Moolji1, Erika MacIntyre1,2, Maria Castro Codesal3
1Division of Pulmonary Medicine, Department of Medicine, University of Alberta, Edmonton, Canada.
Abstract:
The option of tracheostomy and prolonged invasive mechanical ventilation (IMV) for chronic respiratory failure in myotonic dystrophy type 1 (DM1) poses challenges in decision-making. The Myotonic Dystrophy Foundation consensus recommendations on respiratory management do not directly address the implications of this intervention given the progressive physical and cognitive manifestations of DM1. Here, we consider IMV in DM1 using the ethical principles of beneficence, non-maleficence, autonomy and justice. We call for further research on post-tracheostomy morbidity, mortality, and quality of life (QOL) to help guide decision-making. Our ethical analysis has yielded programmatic changes we hope will improve patient outcomes.
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