Wollinsky K H, Mindé A, Schreiber H, Kluger P, Mehrkens H H
Abteilungen Anästhesiologie/Intensivmedizin, Universität Ulm.
Med Klin (Munich). 1995 Apr;90(1 Suppl 1):57-9.
The home care ventilation of patients with chronic respiratory insufficiency is a well-established method. In treating infants and newborns a lot of problems arise that deal with indication, prognosis and management.
We investigated 7 newborns and infants with chronic respiratory insufficiency after cervical spine trauma causing "pentaplegia" or due to inherited neuromuscular disorders (spinal muscular atrophy, myopathy) during homecare ventilation.
In contrast to experience with adults the management of the children with "pentaplegia" was relatively harmless. All were tracheostomized primarily, but 1 tracheostomy could be closed, because the patient finally achieved to be ventilated only during night-time in the iron lung. The 3 children with neuromuscular diseases were ventilated noninvasively by specially fitted nasal masks. Despite coming to the frontiers of feasibility, and taking into account the psychological stress for patients, relatives, doctors and nurses, satisfactory results were obtained.
慢性呼吸功能不全患者的家庭护理通气是一种成熟的方法。在治疗婴儿和新生儿时,出现了许多与适应症、预后和管理相关的问题。
我们调查了7例患有慢性呼吸功能不全的新生儿和婴儿,他们因颈椎创伤导致“四肢瘫”,或因遗传性神经肌肉疾病(脊髓性肌萎缩症、肌病)接受家庭护理通气。
与成人的经验相反,对“四肢瘫”儿童的管理相对无害。所有患儿最初均行气管切开术,但有1例气管造口可以关闭,因为该患者最终仅在夜间使用铁肺进行通气。3例患有神经肌肉疾病的儿童通过特制的鼻面罩进行无创通气。尽管已达到可行性的极限,并考虑到对患者、亲属、医生和护士的心理压力,但仍取得了令人满意的结果。