| Non-invasive Mechanical Ventilator Care for the Patients with Advanced Neuromuscular Disease. |
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Kang, Seong Woong , Park, Jung Hyun , Ryu, Ho Hyun , Kang, Yeoun Seung , Moon, Jae Ho |
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Department of Rehabilitation Medicine and Rehabilitation Institute of Muscular Disease, Yonsei University College of Medicine, Korea. bskwon@dankook.ac.kr |
| 말기 신경근육계 환자에서 비침습적 호흡기 관리 |
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강성웅, 박중현, 류호현, 강연승, 문재호 |
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연세대학교 의과대학 재활의학교실 및 재활의학연구소 |
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| Abstract |
Objective
The usage of mechanical ventilator has been an issue in advanced stage of most neuromuscular diseases. The patients experience hypoventilation symptoms and usually die from pulmonary complications at last. Besides traditional invasive mechanical ventilation, non-invasive intermittent positive pressure ventilation (NIPPV) has provided an alternative treatment option. We evaluated the effects of NIPPV.
Method
We applied NIPPV method to the patients with advanced neuromuscular disease who were hospitalized due to ventilatory failure, who visit our outpatient clinic due to hypercapnic symptoms, or who showed hypercapnia on a routine follow-up. To evaluate ventilatory status, blood gas tensions were analyzed by the arterial blood gas analysis and/or pulse-oxymeter and capnometer. Overnight pulse- oxymeter monitorings were done whenever necessary.
Results
Thirty patients were managed with NIPPV successfully. In five cases, invasive IPPV with tracheostomy at admission was switched to NIPPV. Three patients who had been intubated to receive IPPV were transferred to NIPPV without being tracheostomized.
Conclusion
NIPPV can be used safely and effectively as an alternative method of ventilatory support for the patients with advanced neuromuscular disease who show ventilatory failure. It would relieve symptoms and signs of hypoventilation and prevent the acute respiratory muscle decompensation, if applied before overt ventilatory failure. (J Korean Acad Rehab Med 2004; 28: 71-77) |
| Key Words:
Non-invasive intermittent positive pressure ventilation, Neuromuscular disease, Hypoventilation, Hypercapnea, Pulmonary rehabilitation |
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