[Periodic nocturnal ventilation using an Emerson chest respirator as an alternative to permanent tracheostomy with positive pressure ventilation in patients with idiopathic scoliosis and severe global respiratory insufficiency].

Sustained success was achieved in treating a 40-year-old patient who had had severe progressive thoracic kyphoscoliosis since childhood and developed cardiorespiratory failure with terminal alveolar hypoventilation and hypoxemia due to acute pulmonary infection. On emergency admission to this hospital mechanically controlled ventilation by tracheostomy tube produced a remarkable improvement in cardiorespiratory function. Weakness of the respiratory muscles made complete disconnection from ventilatory support impossible. Instead of positive pressure ventilation by tracheostomy tube with resultant patient invalidity, nighttime external negative pressure ventilation with an Emerson chest respirator was started leaving the patient free for daytime activity. This type of ventilation is a simple, effective and well tolerated long-term treatment at low cost. The patient has been using it nightly at home for over 6 months and no problems have arisen. These findings show that intensive care is indicated in patients with severe thoracic kyphoscoliosis and cardiorespiratory failure since long-term treatment of terminal hypoventilation and cardiorespiratory failure is possible with a cheap and simple nocturnal ventilation system.