Lamid S, Ragalie G F, Welter K
J Am Paraplegia Soc. 1985 Apr;8(2):33-7. doi: 10.1080/01952307.1985.11785933.
During a two-year period we admitted 13 respirator-dependent quadriplegic patients to the spinal cord injury service at Wood VAMC for weaning from a mechanical ventilator, and rehabilitation. The patients were sent to the Spinal Cord Injury Center because initial weaning attempts from the respirator at other medical centers were unsuccessful. We successfully weaned them from the respirator, and at the time of discharge, only two patients required an indwelling tracheostomy tube for suction. The time required for weaning off the respirator varied from two days to 14 months. Most of the patients were discharged and many of them could independently perform the activities of daily living. We conclude that are four main factors which influence the successful weaning of dependent quadriplegics from the mechanical ventilator: alleviation of patient's anxiety and depression; family support; close working relationship between staff; prevention of complications such as pneumonia and urinary tract infections.
在两年时间里，我们收治了13名依赖呼吸机的四肢瘫痪患者，将他们送到伍德退伍军人医疗中心的脊髓损伤科，进行脱机和康复治疗。这些患者被送到脊髓损伤中心，是因为在其他医疗中心最初的脱机尝试均未成功。我们成功地使他们脱机，出院时，只有两名患者需要留置气管造口管进行吸痰。脱机所需时间从两天到14个月不等。大多数患者已出院，其中许多人能够独立进行日常生活活动。我们得出结论，影响依赖呼吸机的四肢瘫痪患者成功脱机有四个主要因素：缓解患者的焦虑和抑郁；家庭支持；工作人员之间密切的工作关系；预防并发症，如肺炎和尿路感染。
