Mechanical ventilation care in severe childhood neurological disorders

• Published in: Brain & development (Tokyo. 1979) 2001-12, Vol.23 (8), p.796-800
• Main Authors: Sasaki, Masayuki, Sugai, Kenji, Fukumizu, Michio, Hanaoka, Shigeru, Kaga, Makiko
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Biological and medical sciences; Child; Child, Preschool; Diseases of striated muscles. Neuromuscular diseases; Home mechanical ventilation care; Humans; Infant; Male; Medical ethics; Medical sciences; Neurodegenerative Diseases - complications; Neurodegenerative Diseases - diagnosis; Neurodegenerative Diseases - mortality; Neurology; Neuromuscular Diseases - complications; Neuromuscular Diseases - diagnosis; Neuromuscular Diseases - mortality; Neuromuscular disorders; Prognosis; Progressive central nervous system disorders; Quality of Life; Respiration, Artificial; Respiratory insufficiency; Respiratory Insufficiency - etiology; Respiratory Insufficiency - mortality; Respiratory Insufficiency - therapy; Retrospective Studies; Survival Rate
• ISSN: 0387-7604; 1872-7131
• DOI: 10.1016/S0387-7604(01)00317-5

Forty-five patients underwent long-term life-sustaining mechanical ventilation care in the Child Neurology Ward, National Center Hospital for Mental, Nervous and Muscular Disorders from 1990 to 2000. Twenty patients had chronic respiratory insufficiency due to neuromuscular disorders, nine of whom underwent home mechanical ventilation care. Nineteen of the 45 patients had chronic respiratory insufficiency due to progressive central nervous system disorders, three of whom underwent home mechanical ventilation care. Six patients with chronic respiratory insufficiency due to the sequelae of transient events were on ventilation, two of whom underwent home mechanical ventilation care. In some patients, especially ones with neuromuscular disorders, mechanical ventilation care is very useful for improving their daily activity and quality of life. In other patients, however, mechanical ventilation care is merely a means of prolonging life without visible improvement of their quality of life. As medical resources are limited, home mechanical ventilation care is a recommended method for patients who need life-sustaining mechanical ventilation care. Considering an individual or social consensus, the indication of long-term life-sustaining mechanical ventilation care for chronic respiratory insufficiency due to severe childhood neurological disorders should be further discussed.