Weaning from prolonged invasive ventilation in motor neurone disease: analysis of outcomes and survival
| العنوان: | Weaning from prolonged invasive ventilation in motor neurone disease: analysis of outcomes and survival |
|---|---|
| المؤلفون: | Ian E. Smith, John M. Shneerson, Vidya Nadig, Rebecca Chadwick, Nicholas Oscroft |
| المساهمون: | Papworth Hospital NHS Trust, Cleveland Clinic |
| المصدر: | Journal of Neurology, Neurosurgery and Psychiatry Journal of Neurology, Neurosurgery and Psychiatry, BMJ Publishing Group, 2010, 82 (6), pp.643. ⟨10.1136/jnnp.2009.193631⟩ |
| بيانات النشر: | HAL CCSD, 2010. |
| سنة النشر: | 2010 |
| مصطلحات موضوعية: | Male, medicine.medical_specialty, Neuromuscular disease, medicine.medical_treatment, Kaplan-Meier Estimate, 03 medical and health sciences, 0302 clinical medicine, medicine, Intubation, Weaning, Humans, Respiratory function, 030212 general & internal medicine, Aged, Retrospective Studies, MOTOR NEURON DISEASE, Ventilators, Mechanical, business.industry, Tracheal intubation, Retrospective cohort study, Middle Aged, medicine.disease, Respiration, Artificial, 3. Good health, Surgery, Psychiatry and Mental health, Treatment Outcome, Anesthesia, Breathing, Female, Neurology (clinical), business, Motor neurone disease, Ventilator Weaning, 030217 neurology & neurosurgery |
| الوصف: | International audience; Introduction: Non-invasive ventilation (NIV) improves prognosis in patients with Motor Neurone Disease (MND) in the absence of major bulbar involvement. However, some experience a rapid and unexpected decline in respiratory function and may undergo emergency tracheal intubation. Weaning from invasive ventilation can be difficult and reported independence from invasive ventilation is uncommon with poor prognosis. The outcomes of patients with MND referred to a specialist weaning service following emergency tracheal intubation were examined and compared with MND patients electively initiating NIV. Methods: A case note review was performed on all patients with MND invasively ventilated and referred to a specialist weaning service between 1992 and 2007. Outcomes were compared with those electively commenced on NIV during the same period. Results: Thirty patients were referred for weaning from invasive ventilation which was started in 17 before MND was diagnosed. Fourteen patients (47%) were weaned from invasive ventilation but still required NIV, 13 failed to wean and three died. Seventeen were discharged home from hospital. Median survival from tracheal intubation was 13.7 months (95% CI 0-30.8) for those previously diagnosed and 7.2 months (95% CI 5.1-9.4) for those not previously known to have MND. Comparison with patients initiated electively on NIV demonstrated similar survival estimates to that from emergency intubation (median 9.4 (95% CI 6.9 - 12.0) vs. 7.8 (95% CI 2.6 - 12.9) months respectively). Conclusion: The prognosis in MND following acute respiratory failure and intubation is not always complete ventilator dependence if patients are offered a comprehensive weaning programme. |
| اللغة: | English |
| تدمد: | 0022-3050 1468-330X |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::230f26a6f94a604763b80a0f299a22a1 https://hal.archives-ouvertes.fr/hal-00591162 |
| حقوق: | OPEN |
| رقم الأكسشن: | edsair.doi.dedup.....230f26a6f94a604763b80a0f299a22a1 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 00223050 1468330X |
|---|