Two cases of intractable neurological disease diagnosed with difficulty in withdrawal from ventilator management after emergency transportation

Abstract

The prevalence of intractable neurological diseases is increasing especially as the number of newly diagnosed elderly people has increased, which results in the aging of the patient population. In emergency cases, therefore, the opportunity to diagnose intractable diseases is also increasing. We experienced two cases diagnosed with neuromuscular diseases who were difficult to wean from mechanical ventilation after emergency transportation. Although the diagnoses were made after tracheostomy in both cases, we believe that early diagnosis contribute to either the avoidance of unexpected and sudden changes or to improved prognosis. Moreover, a definitive diagnosis reduces the financial and mental burdens on patients and their families. We suggest citing undiagnosed neuromuscular diseases as a differential diagnosis because a certain number of patients may have them. This is particularly applicable to patients who may be difficult to wean from mechanical ventilation, despite absent organic airway or lung abnormalities.