Mikesch Martin, Reichenpfader Peter
Interne Abteilung, Palliativkonsiliardienst/mobiles Palliativteam, Landesklinikum Waldviertel Zwettl, Zwettl, Austria.
Wien Med Wochenschr. 2009 Dec;159(23-24):599-603. doi: 10.1007/s10354-009-0729-x.
This example of an 80-year-old patient with severe lung disease and respiratory failure demonstrates the difficult relationship between the patient's needs, physical symptoms, and social problems. This man decides after a prolonged and difficult in-patient treatment actively for home ventilation rather than die of respiratory failure. He opts for tracheostomy and invasive ventilation because he cannot handle non-invasive mask-ventilation sufficiently by himself. It requires professional communication and support to gain the acceptance of family and caregivers for home ventilation. A survey of existing data on end of life decision-making in end-stage lung disease is given.
这位80岁患有严重肺部疾病和呼吸衰竭的患者案例，展现了患者需求、身体症状和社会问题之间复杂的关系。在经历了漫长而艰难的住院治疗后，这名男子积极决定选择居家通气，而非死于呼吸衰竭。他选择了气管切开术和有创通气，因为他自己无法充分耐受无创面罩通气。要让家人和护理人员接受居家通气，需要专业的沟通和支持。本文给出了对晚期肺病临终决策现有数据的一项调查。
