{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T05:45:04Z","timestamp":1788414304056,"version":"build-2803163510"},"reference-count":16,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"8","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":["Am J Phys Med Rehabil"],"published-print":{"date-parts":[[2024,8]]},"abstract":"<jats:title>Abstract<\/jats:title>\n          <jats:p>Despite new effective medications, patients with spinal muscular atrophy types 1\u20133 can continue to have inadequate cough flows to prevent episodes of acute respiratory failure. Ventilator unweanable intubated patients are thought to require tracheostomy tubes. As a result, potentially beneficial medications may be discontinued and patients die despite receiving these medications. Three cases are presented of medically treated, physically strengthening children, with spinal muscular atrophy type 1. All three subsequently died or underwent tracheotomy. However, there is no evidence of extubation attempts to noninvasive ventilatory support settings or optimal mechanical insufflation-exsufflation despite this option being described to be over 98% successful for extubating unweanable medically untreated children with spinal muscular atrophy 1.<\/jats:p>","DOI":"10.1097\/phm.0000000000002467","type":"journal-article","created":{"date-parts":[[2024,3,26]],"date-time":"2024-03-26T09:14:35Z","timestamp":1711444475000},"page":"e98-e101","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":2,"title":["Spinal Muscular Atrophy Mortality Despite Novel Medications"],"prefix":"10.1097","volume":"103","author":[{"given":"John R.","family":"Bach","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nayara","family":"Concei\u00e7\u00e3o","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miguel R.","family":"Goncalves","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2024,3,25]]},"reference":[{"key":"bib2-20250616","doi-asserted-by":"crossref","first-page":"174","DOI":"10.1378\/chest.103.1.174","article-title":"Intermittent positive pressure ventilation via the mouth as an alternative to tracheostomy for 257 ventilator users","volume":"103","year":"1993","journal-title":"Chest"},{"key":"bib3-20250616","doi-asserted-by":"crossref","first-page":"3017","DOI":"10.1016\/S0140-6736(16)31408-8","article-title":"Treatment of infantile-onset spinal muscular atrophy with nusinersen: a phase 2, open-label, dose-escalation study","volume":"388","year":"2016","journal-title":"Lancet"},{"key":"bib4-20250616","doi-asserted-by":"crossref","first-page":"461","DOI":"10.1097\/PHM.0b013e318174e4c7","article-title":"Peak cough flows: standard values for children and 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