Non‐Invasive Versus Invasive Ventilation for Acute Respiratory Failure in Neuromuscular Diseases: A Systematic Scoping Review

ABSTRACT Acute respiratory failure is the most common life‐threatening complication of neuromuscular disease. Ventilatory support using invasive or non‐invasive methods is often required. However, the most effective form of support for patients with neuromuscular diseases and acute respiratory failure remains unclear. This review summarizes the existing literature on the efficacy of non‐invasive ventilation compared with invasive ventilation as first‐line support for this population. A systematic search was conducted in PubMed, the Cochrane Central Register of Controlled Trials, and Igaku Chuo Zasshi for articles published until July 2024. Two reviewers independently screened studies for eligibility, assessed methodological quality, and extracted relevant data. Of 3758 studies identified, three observational studies met the inclusion criteria, encompassing 338 patients. Among them, 130 received non‐invasive ventilation and 208 received invasive ventilation. Due to variability in populations, interventions, and reported outcomes, data were summarized descriptively. Mortality rate was lower in patients receiving non‐invasive ventilation, with reported rates from 0% to 14%, compared with 16% to 57% in the invasive ventilation group. Length of intensive care unit stay and duration of ventilation were shorter in the non‐invasive ventilation group, ranging from 7 to 13.6 days and from 4 to 15.7 days, respectively, compared with 13 to 47.1 days and 9 to 21.7 days in the invasive ventilation group. Although current evidence is limited, findings suggest non‐invasive ventilation may be a viable alternative to invasive ventilation in selected patients. Successful ventilatory support should be tailored to each patient's condition, including bulbar dysfunction, progressive symptoms, or severe carbon dioxide retention.