Chevrolet J C
Soins intensifs médicaux, Hôpital cantonal universitaire, Genève.
Ther Umsch. 1990 Nov;47(11):890-5.
Ventilatory failure, often complicated by pulmonary infection, is a common cause of death in neuromuscular disorders. When severe enough, only intubation and mechanical ventilation can avoid a fatal outcome. In acute, reversible neuromuscular problems, mechanical ventilation is simple and safe, even if long lasting. Pulmonary function tests, particularly repeated vital capacity measurements, are very useful to predict respiratory failure and conduct weaning trials from the respirator. In chronic, progressive and debilitating neuromuscular disorders, to intubate or not remains an ethical dilemma. In an hospital admitting such patients, a clear and explicit consensus about the general policy for the treatment of chronic neuromuscular patients should have been previously discussed to avoid erratic therapeutic options.
呼吸衰竭常并发肺部感染，是神经肌肉疾病常见的死亡原因。病情严重时，只有插管和机械通气才能避免致命后果。在急性、可逆性神经肌肉问题中，机械通气简单且安全，即便持续时间较长。肺功能测试，尤其是反复测量肺活量，对于预测呼吸衰竭和进行撤机试验非常有用。在慢性、进行性和使人衰弱的神经肌肉疾病中，是否插管仍然是一个伦理困境。在收治此类患者的医院，应事先就慢性神经肌肉疾病患者的总体治疗策略达成明确共识，以避免治疗选择的随意性。
