Bach John Robert, Goncalves Miguel
Department of Physical Medicine and Rehabilitation, University of Medicine and Dentistry of New Jersey-New Jersey Medical School, Newark, New Jersey 07103, USA.
Am J Phys Med Rehabil. 2004 Jul;83(7):560-8. doi: 10.1097/01.phm.0000130027.80861.b8.
This case series of ventilator-dependent patients with neuromuscular disease who had no ventilator-free breathing ability demonstrates that decannulation and switching to continuous noninvasive intermittent positive-pressure ventilation combined with regular lung expansion therapy can result in improvements in pulmonary function and at least partial ventilator weaning. These six patients were also managed using mechanical insufflation-exsufflation for regular lung expansion and cough assistance. Thus, some ventilator users with neuromuscular disease can benefit from tracheostomy tube decannulation and transition to noninvasive intermittent positive-pressure ventilation and assisted coughing for ventilator weaning to predominantly nocturnal-only use.
本病例系列研究的是依赖呼吸机且无自主呼吸能力的神经肌肉疾病患者，结果表明，拔除气管造口插管并改用持续无创间歇性正压通气联合定期肺扩张治疗，可改善肺功能并至少实现部分脱机。这6例患者还采用了机械吸气-呼气法进行定期肺扩张和咳嗽辅助。因此，一些使用呼吸机的神经肌肉疾病患者可受益于气管造口插管拔除，转而采用无创间歇性正压通气和辅助咳嗽进行脱机，从而主要改为仅在夜间使用呼吸机。
