Abstract
Non-Invasive Ventilation (NIV) has become widely used procedure to support patients with chronic and acute respiratory insufficiency.However no basis for the introduction of this procedure has established.We herein report the experience of NIV for acute respiratory insufficiency of severely disabled children.
We used NIV for 8 severely disabled children.All of them had various degreesof ventilatory impairment, upper or middle airway obstructions and repeated episodes of airway infections.Seven cases were treated with BiPAP®Harmony S/T (Respironics.Inc.) in acute respiratory disturbances such as pneumonia and acute exacerbation of chronic respiratory failure. Another Down syndrome patient with subluxation of atlantoaxial joint was adopted Quantum® PSV (HEALTHDYNE TECHNOLOGIES Inc.) for withdrawing from intermittent mandatory ventilation.
All 7 patients with acute respiratory disturbance showed rapid improvement of respiratory symptoms, oxygenation and acidosis.Although hypercapnea was slightly worsened in one patient, we could avoid intubations to all of them after all.
We could also extubate the Down syndrome patient successfully by using Quantum®PSV.
NIV is thought to be a useful procedure to manage acute respiratory insufficiency in severely disabled children.We propose more aggressive trial of NIV before starting intermittent mandatory ventilation.(JJPP 2003: 14: 152-155)
