본문 바로가기
KERD
논문KCI 등재

Successful Extubation After Weaning Failure by Noninvasive Ventilation in Patients With Neuromuscular Disease: Case Series

2

조회

0

다운로드

1

인용

0

참고문헌

키워드

주제분류재활의학

초록

Objective To report successful cases of extubation from invasive mechanical ventilation at our institution using pulmonary rehabilitation consisting of noninvasive ventilation (NIV) in neuromuscular patients with experience of reintubation.Methods Patients who experienced extubation failure via the conventional weaning strategy but afterwards had extubation success via NIV were studied retrospectively. Continuous end-tidal CO2 (ETCO2) and pulse oxyhemoglobin saturation (SpO2) monitoring were performed. Extubation success was defined as a state not requiring invasive mechanical ventilation via endotracheal tube or tracheotomy during a period of at least 5 days. Results A total of 18 patients with ventilatory failure who initially experienced extubation failure were finally placed under part-time NIV after extubation. No patient had any serious or long-term adverse effect from NIV, and all patients left the hospital alive.Conclusion NIV may promote successful weaning in neuromuscular patients with experience of reintubation.

Abstract

Objective To report successful cases of extubation from invasive mechanical ventilation at our institution using pulmonary rehabilitation consisting of noninvasive ventilation (NIV) in neuromuscular patients with experience of reintubation.Methods Patients who experienced extubation failure via the conventional weaning strategy but afterwards had extubation success via NIV were studied retrospectively. Continuous end-tidal CO2 (ETCO2) and pulse oxyhemoglobin saturation (SpO2) monitoring were performed. Extubation success was defined as a state not requiring invasive mechanical ventilation via endotracheal tube or tracheotomy during a period of at least 5 days. Results A total of 18 patients with ventilatory failure who initially experienced extubation failure were finally placed under part-time NIV after extubation. No patient had any serious or long-term adverse effect from NIV, and all patients left the hospital alive.Conclusion NIV may promote successful weaning in neuromuscular patients with experience of reintubation.

참고문헌 (16)

  1. Ferrer M, "Non-invasive ventilation after extubation in hypercapnic patients with chronic respiratory disorders: randomised controlled trial", Lancet, 374, pp.1082~1088 (2009)
  2. Esteban A, "Noninvasive positivepressure ventilation for respiratory failure after extubation", N Engl J Med, 350, pp.2452~2460 (2004)
  3. Nava S, "Noninvasive ventilation to prevent respiratory failure after extubation in high-risk patients", Crit Care Med, 33, pp.2465~2470 (2005)
  4. Burns KE, "Use of non-invasive ventilation to wean critically ill adults off invasive ventilation: meta-analysis and systematic review", BMJ, 338, pp.b1574~ (2009)
  5. Panitch HB, "The pathophysiology of respiratory impairment in pediatric neuromuscular diseases", Pediatrics, 123(Suppl 4), pp.S215~218 (2009)
  6. Mehta S, "Neuromuscular disease causing acute respiratory failure", Respir Care, 51, pp.1016~1021 (2006)
  7. Bach JR, "Extubation of patients with neuromuscular weakness: a new management paradigm", Chest, 137, pp.1033~1039 (2010)
  8. Bach JR, "Neuromuscular ventilatory insufficiency:effect of home mechanical ventilator use v oxygen therapy on pneumonia and hospitalization rates", Am J Phys Med Rehabil, 77, pp.8~19 (1998)
  9. Girault C, "Noninvasive ventilation as a systematic extubation and weaning technique in acute-onchronic respiratory failure: a prospective, randomized controlled study", Am J Respir Crit Care Med, 160, pp.86~92 (1999)
  10. Bach JR, "Open gastrostomy for noninvasive ventilation users with neuromuscular disease", Am J Phys Med Rehabil, 89, pp.1~6 (2010)
  11. Kilger E, "Effects of noninvasive positive pressure ventilatory support in non-COPD patients with acute respiratory insufficiency after early extubation", Intensive Care Med, 25, pp.1374~1380 (1999)
  12. Rabinstein AA, "Update on respiratory management of critically ill neurologic patients", Curr Neurol Neurosci Rep, 5, pp.476~482 (2005)
  13. Spitzer AR, "Neuromuscular causes of prolonged ventilator dependency", Muscle Nerve, 15, pp.682~686 (1992)
  14. Bach JR, "Spinal muscular atrophy type 1: a noninvasive respiratory management approach", Chest, 117, pp.1100~1105 (2000)
  15. Bach JR, "Duchenne muscular dystrophy:continuous noninvasive ventilatory support prolongs survival", Respir Care, 56, pp.744~750 (2011)
  16. Meduri GU, "Noninvasive positive pressure ventilation via face mask: first-line intervention in patients with acute hypercapnic and hypoxemic respiratory failure", Chest, 109, pp.179~193 (1996)

관련 논문AI추천

이 간행물의 다른 논문 (23건)