A Research on the Management of Ventilatory Insufficiency in Patients with Neuromuscular Diseases.
- Author:
Dong Hyun KIM
1
;
Seong Woong KANG
;
Wonah CHOI
;
Jae Ho MOON
;
Jong Hoon BAEK
;
Seung Ho CHOI
;
Jung Hyun PARK
;
Yong Beom SHIN
;
Jung Hwan SEO
Author Information
1. Department of Rehabilitation Medicine and Pulmonary Rehabilitation Center, Yonsei University College of Medicine, Korea. kswoong@yuhs.ac
- Publication Type:Original Article
- Keywords:
Neuromuscular disease;
Non-invasive ventilation;
Pulmonary rehabilitation;
Mechanical ventilation
- MeSH:
Amyotrophic Lateral Sclerosis;
Continuous Positive Airway Pressure;
Humans;
Korea;
Muscular Atrophy, Spinal;
Muscular Diseases;
Muscular Dystrophy, Duchenne;
Neuromuscular Diseases;
Noninvasive Ventilation;
Quality of Life;
Respiration, Artificial;
Tracheostomy;
Ventilators, Mechanical
- From:Journal of the Korean Academy of Rehabilitation Medicine
2010;34(3):347-354
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
OBJECTIVE: To investigate the real condition of pulmonary rehabilitation for patients with advanced neuromuscular diseases (NMDs) on mechanical ventilation in Korea. METHOD: In order to estimate current state of pulmonary rehabilitative management, chart review and pulmonary function evaluation were conducted in a total of 267 NMD patients who had applied mechanical home ventilator in our center from March 2001 to December 2008. RESULTS: Total 267 patients were included: 95 with Duchenne muscular dystrophy, 69 with other types of myopathy, 83 with amyotrophic lateral sclerosis (ALS), 20 with spinal muscular atrophy. Among them, 18 who were previously intubated and 17 patients who had undergone tracheostomy were switched into volume-limited non-invasive ventilation (NIV). At the time of hospital discharge, 234 patients were applied NIV successfully. Twenty other patients who once used continuous positive airway pressure (CPAP) or bilevel positive airway pressure (BiPAP) ventilators inappropriately were switched into volume-limited NIV. However, 20 patients who had successfully applied NIV first underwent tracheostomy due to exacerbation of underlying disease. CONCLUSION: Adequate pulmonary management is the only promising method to prevent lethal complications, and to prolong life span of advanced NMD patients. We assume that more NMD patients can improve their quality of life and prolong their life through proper pulmonary rehabilitation including regular pulmonary function check-ups and ventilatory state monitoring as well as early NIV application.
