Department of Physiotherapy, Brompton Hospital, London, UK.
Respir Care. 2011 Nov;56(11):1840-3. doi: 10.4187/respcare.01155. Epub 2011 May 20.
With the recent increased use of noninvasive ventilation, the prognoses of children with neuromuscular disease has improved significantly. However, children with muscle weakness remain at risk for recurrent respiratory infection and atelectasis. We report the case of a young girl with type 1 spinal muscular atrophy who was dependent on noninvasive ventilation, and in whom conventional secretion-clearance physiotherapy became insufficient to clear secretions. We initiated high-frequency chest-wall oscillation (HFCWO) as a rescue therapy, and she had improved self-ventilation time. This is the first case report of HFCWO for secretion clearance in a severely weak child with type 1 spinal muscular atrophy. In a patient with neuromuscular disease and severe respiratory infection and compromise, HFCWO can be used safely in combination with conventional secretion-clearance physiotherapy.
随着无创通气的广泛应用，神经肌肉疾病患儿的预后得到了显著改善。然而，存在肌肉无力的患儿仍有反复呼吸道感染和肺不张的风险。我们报告了一例 1 型脊髓性肌萎缩症依赖无创通气的年轻女孩，常规的排痰物理治疗已不足以清除分泌物。我们开始使用高频胸壁振荡（HFCWO）作为抢救治疗，她的自主通气时间得到了改善。这是首例 1 型脊髓性肌萎缩症严重肌无力患儿应用 HFCWO 清除分泌物的病例报告。在神经肌肉疾病、严重呼吸道感染和呼吸功能受损的患者中，HFCWO 可与常规排痰物理治疗安全地联合应用。
