{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,16]],"date-time":"2025-12-16T08:10:23Z","timestamp":1765872623871,"version":"3.48.0"},"reference-count":15,"publisher":"BMJ","issue":"11","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2019,9,17]]},"published-print":{"date-parts":[[2019,11]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Neuromuscular diseases (NMD) are characterised by progressive muscular impairment. The muscle weakness is directly related to respiratory muscles weakness, causing reduction in vital capacity, especially when associated with mechanical ventilation (MV). Conventional MV weaning in NMD is generally difficult. Weaning process can be conducted in protocols such as: \u2018T\u2019 piece or Pressure Support Ventilaton. Weaning failure is frequent because of muscle weakness. Protocol aim is to assess the effects of different weaning protocols in NMD patients receiving invasive MV in weaning success rate, duration of weaning, intensive care unit (ICU) stay, hospital stay and ICU mortality.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and analysis<\/jats:title>\n                    <jats:p>A search will be carried in the Cochrane Neuromuscular Specialised Register, MEDLINE, EMBASE, Web of Science, Scopus, United States National Institutes of Health Clinical Trials Registry, ClinicalTrials.gov and WHO International Clinical Trial Registry Protal, of randomised controlled trials (RCTs) and quasi-RCTs. Inclusion criteria of individuals are adults (above 16 years old) and children (from 5 to 16 years old), with clinical diagnosis of NMD (muscular dystrophy, amyotrophic lateral sclerosis, congenital myasthenia, myasthenia gravis, congenital myopathy, spinal muscular atrophy, Guillian Barr\u00e9 Syndrome, severe inherited neuropathies, metabolic myopathies, inflammatory myopathies, mitochondrial diseases) of any gender. All patients ventilated for at least 48 hours due to respiratory failure and clinically considered ready for weaning. Other respiratory or cardiovascular diagnosis associated will not be included. Intervention assessed will be weaning from MV using a protocol with 30 min to 2 hours of spontaneous breathing trial at the end point. All comparisons of different protocols will be considered.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Ethics and dissemination<\/jats:title>\n                    <jats:p>Formal ethical approval is not required as primary data will not be collected, since it will be a systematic review. All studies included should have ethical committee approval. The results will be disseminated through a peer-reviewed publication and in conferences and congresses or symposia.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>PROSPERO registration number<\/jats:title>\n                    <jats:p>CRD42019117393.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2019-029890","type":"journal-article","created":{"date-parts":[[2019,11,5]],"date-time":"2019-11-05T07:44:39Z","timestamp":1572939879000},"page":"e029890","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":3,"title":["Weaning from mechanical ventilation in people with neuromuscular disease: protocol for a systematic review"],"prefix":"10.1136","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5089-0564","authenticated-orcid":false,"given":"Saint Clair Gomes","family":"Bernardes Neto","sequence":"first","affiliation":[{"name":"RENORBIO \u2013 Biotechnology, Universidade Federal do Rio Grande do Norte, Natal, Brazil"},{"name":"PneumocardioVascular LAB, Hospital Universit\u00e1rio Onofre Lopes, Empresa Brasileira de Servi\u00e7os Hospitalares (EBSERH) & Laborat\u00f3rio de Inova\u00e7\u00e3o Tecnol\u00f3gica em Reabilita\u00e7\u00e3o. Departamento de Fisioterapia, Universidade Federal do Rio Grande do Norte, Natal, RN, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7974-4333","authenticated-orcid":false,"given":"Rodrigo","family":"Torres","sequence":"additional","affiliation":[{"name":"Physiotherapy, University of Chile, Santiago, Chile"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0301-4702","authenticated-orcid":false,"given":"\u00cdllia","family":"Lima","sequence":"additional","affiliation":[{"name":"Faculdade de Ci\u00eancias da Sa\u00fade do Trairi - FACISA, Universidade Federal do Rio Grande do Norte, Santa Cruz, RN, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4817-9364","authenticated-orcid":false,"given":"Vanessa R","family":"Resqueti","sequence":"additional","affiliation":[{"name":"PneumocardioVascular LAB, Hospital Universit\u00e1rio Onofre Lopes, Empresa Brasileira de Servi\u00e7os Hospitalares (EBSERH) & Laborat\u00f3rio de Inova\u00e7\u00e3o Tecnol\u00f3gica em Reabilita\u00e7\u00e3o. Departamento de Fisioterapia, Universidade Federal do Rio Grande do Norte, Natal, RN, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4938-7018","authenticated-orcid":false,"given":"Guilherme A F","family":"Fregonezi","sequence":"additional","affiliation":[{"name":"RENORBIO \u2013 Biotechnology, Universidade Federal do Rio Grande do Norte, Natal, Brazil"},{"name":"PneumocardioVascular LAB, Hospital Universit\u00e1rio Onofre Lopes, Empresa Brasileira de Servi\u00e7os Hospitalares (EBSERH) & Laborat\u00f3rio de Inova\u00e7\u00e3o Tecnol\u00f3gica em Reabilita\u00e7\u00e3o. Departamento de Fisioterapia, Universidade Federal do Rio Grande do Norte, Natal, RN, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2019,11,4]]},"reference":[{"key":"2025121600061181000_9.11.e029890.1","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1002\/mus.23771","article-title":"Exercise in neuromuscular disease","volume":"48","author":"Anziska","year":"2013","journal-title":"Muscle Nerve"},{"key":"2025121600061181000_9.11.e029890.2","doi-asserted-by":"crossref","first-page":"161","DOI":"10.1016\/j.ncl.2011.09.010","article-title":"Neuromuscular disorders and acute respiratory failure: diagnosis and management","volume":"30","author":"Rezania","year":"2012","journal-title":"Neurol Clin"},{"key":"2025121600061181000_9.11.e029890.3","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.00182208"},{"key":"2025121600061181000_9.11.e029890.4","doi-asserted-by":"crossref","first-page":"450","DOI":"10.5535\/arm.2017.41.3.450","article-title":"Successful extubation after weaning failure by noninvasive ventilation in patients with neuromuscular disease: case series","volume":"41","author":"Kim","year":"2017","journal-title":"Ann Rehabil Med"},{"key":"2025121600061181000_9.11.e029890.5","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.200304-489CP"},{"key":"2025121600061181000_9.11.e029890.6","doi-asserted-by":"publisher","DOI":"10.1378\/chest.09-2144"},{"key":"2025121600061181000_9.11.e029890.7","doi-asserted-by":"publisher","DOI":"10.1164\/ajrccm.158.2.9711045"},{"key":"2025121600061181000_9.11.e029890.8","doi-asserted-by":"crossref","first-page":"274","DOI":"10.1186\/s13054-015-0993-7","article-title":"Clinical review: intensive care unit acquired weakness","volume":"19","author":"Hermans","year":"2015","journal-title":"Critical Care"},{"key":"2025121600061181000_9.11.e029890.9","doi-asserted-by":"crossref","first-page":"814","DOI":"10.1164\/ajrccm\/144.4.814","article-title":"Repeated vital capacity measurements as predictive parameters for mechanical ventilation need and weaning success in the Guillain-Barr\u00e9 syndrome","volume":"144","author":"Chevrolet","year":"1991","journal-title":"Am Rev Respir Dis"},{"key":"2025121600061181000_9.11.e029890.10","first-page":"65","article-title":"Ventilator weaning and spontaneous breathing trials; an educational review","volume":"4","author":"Zein","year":"2016","journal-title":"Emerg"},{"key":"2025121600061181000_9.11.e029890.11","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.201411-2011ST"},{"key":"2025121600061181000_9.11.e029890.12","first-page":"37","article-title":"Characteristics and outcome of patients with difficult weaning from mechanical ventilation: an 18 years' experience of a respiratory intermediate unit attached to a pulmonary department","volume":"19","author":"Tsara","year":"2015","journal-title":"Hippokratia"},{"key":"2025121600061181000_9.11.e029890.13","doi-asserted-by":"crossref","first-page":"1477","DOI":"10.1164\/rccm.201607-1338OC","article-title":"Effort to breathe with various spontaneous breathing trial techniques. 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