Night ventilation by body respirators for patients in chronic respiratory failure due to late stage Duchenne muscular dystrophy.
Night ventilation by body respirators for patients in chronic respiratory failure due to late stage Duchenne muscular dystrophy.
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因晚期杜氏肌营养不良症而导致慢性呼吸衰竭的患者使用身体呼吸器进行夜间通气。
DOI：
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发表时间：
1981
影响因子：
4.3
通讯作者：
F. Curran
中科院分区：
文献类型：
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作者：
F. Curran
介绍了9例晚期Duchenne肌营养不良症患者的呼吸肌保留治疗方案。结果表明，在中重度呼吸衰竭发生后，有规律、有效的夜间呼吸器支持对白天的气体交换有持续的显着改善，持续时间长达2年。到目前为止，最长的存活时间是28岁时超过4年。夜间通气前PaCO2平均值为60.8 mm Hg，PaO2平均值为59.3 mm Hg。计划开始后的水平分别为45.5(PaCO2)和74.6(PaO2)。这些动脉血气水平对于良好的心肺动态平衡是可以接受的。自该计划开始以来，还没有死亡或心力衰竭的事件。易于将该计划整合到患者的生活方式和家庭中是重要的优势。讨论了设备的成本问题。认为这些患者是临终病人的观点必须是有保留的。早期积极保守治疗包括呼吸机、体位引流、胸部物理治疗配合腹部辅助咳嗽、气管内吸痰和支气管镜检查，以对抗呼吸道感染，减少对慢性限制性肺病(CRLD)患者的气管切开和容量呼吸机的需求。迫切需要研究和开发更好的人体呼吸器设计。急诊医院必须为这些患者做好准备，这些患者现在获得了更独立的生活和更长的寿命。因此，越来越需要这些设施购买储气罐通风机，以处理可能因急性医疗并发症而需要住院的这类患者。
A program of respiratory muscle sparing in 9 patients with late stage Duchenne muscular dystrophy is presented. Results indicate that regular efficient night-time support by body respirator provides a constant significant improvement in daytime gas exchange for periods averaging up to 2 years following the occurrence of moderately severe respiratory failure. Until now, the longest survival is more than 4 years at the age of 28. the average PaCO2 and PaO2 before night ventilation were 60.8mmHg and 59.3mmHg, respectively. The levels after the program was begun were 45.5 (PaCO2) and 74.6 (PaO2). These arterial blood gas levels are acceptable for good cardiopulmonary homeostasis. There have been no deaths or episodes of cardiac failure since the program began. The ease of integrating the program into the patient's lifestyle and home are important advantages. Cost of equipment is discussed. The view that these patients are terminal must be qualified. A case is also made for early aggressive conservative measures including body respirators, postural drainage, chest physiotherapy with abdominal assisted coughing, intratracheal suctioning and bronchoscopy to combat respiratory infection, and decreasing the need of tracheostomy and volume ventilators which can be so disabling to the chronic restrictive lung disease (CRLD) patient. Research and development into better design of body respirators is vitally needed. Acute care hospitals must prepare themselves for such patients who now attain more independent living and longer lifespan. For this reason there is a growing need for these facilities to acquire tank ventilators for handling such patients who may need hospitalization for acute medical complications.