Which restrictive thoracic diseases can be managed successfully with NIV?

The management of restrictive thoracic diseases with noninvasive ventilation (NIV) is particularly effective in conditions characterized by compromised lung mechanics and reduced lung volumes, where the primary issue is often related to muscle strength and mobility of the thoracic wall. In conditions like post-polio syndrome and kyphoscoliosis, the thoracic structure and respiratory muscles are adversely affected, leading to inadequate ventilation and hypoxemia. NIV is beneficial as it can provide the necessary support to improve alveolar ventilation without the complications associated with invasive mechanical ventilation.

In post-polio syndrome, the neuromuscular weakness can lead to significant respiratory muscle impairment, making NIV a suitable intervention to augment breathing and enhance gas exchange. Similarly, kyphoscoliosis alters thoracic compliance and volume, making spontaneous breathing less effective. NIV can help to relieve the work of breathing, reduce airway resistance, and improve oxygenation in these patients.

Other conditions mentioned, such as asthma, bronchitis, chronic bronchitis, and pneumonia, are typically associated with obstructive rather than restrictive pathways of which NIV may not directly address the underlying issues like airway inflammation or secretions, limiting their effectiveness in those scenarios. On the other hand, obesity and obstructive sleep apnea primarily involve the upper