應用機械式吸吐通氣協助一位肌萎縮性脊髓側索硬化症病患清除痰液之成效

Translated title of the contribution: Respiratory Care Experience of a Patient Using Adaptive Support Ventilation during Weaning Process

張 新傑(Hsin-Chieh Chang), 張 莉玉(Li-Yu Chaug), 吳 佳齡(Chia-Ling Wu), 吳 雨珊(Yu-Shan Wu), 官 世華(Shih-Lfua Kuan), 江 玲玲(Ling-Ling Chiang)

Research output: Contribution to journalArticle

Abstract

The neuromuscular disease patients with respiratory muscle weakness use mechanical ventilators in order to avoid respiratory failure. Some patients have become ventilator-dependent due to gradually progressed amyotrophy. This kind of patients not only inspiration muscle but also expiration muscle will be weakness, unable to initiative expectoration, so often need to make use of the external force to assist to do expectoration movements, In tradition only position drainage and suction of the treatment will appear serious hypoxemia and lung atelectasis often also, so it main problem in care is how to clear sputum. Clinically tested, the cough assist machine with MI-E technique is used for neuromuscular disease patients; the machine can clear the sputum effectively.
In this case study there was an Amyotrophic Lateral Sclerosis (ALS) patient, who had used the cough assist machine with MI-E for two months. Obviously, the machine had lessened the patient's sputum accumulation. Its result is described as follows: The lung with atelectasis and can be reexpanded, and uncomfortable in chest and short of breathing phenomenon is reduced, the patient could relatively sleep; The FiO2. was decreased and the mode was changed to volume control instead of pressure control. The monitor was continuously in the therapy process, it find that the MI-E to have a little effect on heartbeat. We can know that it is obviously effectively in the reduction sputum amount from record. Therefore, according to the efficacy of MI-E in this patient. the research to recommend that apply cough assist machine via MI-E to clear sputum in neuromuscular disease.
Original languageTraditional Chinese
Pages (from-to)31-42
Number of pages12
Journal呼吸治療
Volume8
Issue number1
DOIs
Publication statusPublished - 2009

Fingerprint

Weaning
Ventilation
Sputum
Neuromuscular Diseases
Cough
Pulmonary Atelectasis
Mechanical Ventilators
Muscles
Lung
Respiratory Muscles
Muscle Weakness
Amyotrophic Lateral Sclerosis
Suction
Respiratory Insufficiency
Sleep
Respiration
Thorax
Pressure
Therapeutics
Research

Keywords

  • amyotrophic lateral sclerosis
  • mechanical insufflation-exsufflation
  • cough assist machine
  • sputum clearance

Cite this

張新傑(Hsin-Chieh C, 張莉玉(Li-Yu C, 吳佳齡(Chia-Ling W, 吳雨珊(Yu-Shan W, 官世華(Shih-Lfua K, & 江玲玲(Ling-Ling C (2009). 應用機械式吸吐通氣協助一位肌萎縮性脊髓側索硬化症病患清除痰液之成效. 呼吸治療, 8(1), 31-42. https://doi.org/10.6269/JRT.2009.8.1.03

應用機械式吸吐通氣協助一位肌萎縮性脊髓側索硬化症病患清除痰液之成效. / 張新傑(Hsin-Chieh Chang); 張莉玉(Li-Yu Chaug); 吳佳齡(Chia-Ling Wu); 吳雨珊(Yu-Shan Wu); 官世華(Shih-Lfua Kuan); 江玲玲(Ling-Ling Chiang).

In: 呼吸治療, Vol. 8, No. 1, 2009, p. 31-42.

Research output: Contribution to journalArticle

張新傑(Hsin-ChiehC, 張莉玉(Li-YuC, 吳佳齡(Chia-LingW, 吳雨珊(Yu-ShanW, 官世華(Shih-LfuaK & 江玲玲(Ling-LingC 2009, '應用機械式吸吐通氣協助一位肌萎縮性脊髓側索硬化症病患清除痰液之成效', 呼吸治療, vol. 8, no. 1, pp. 31-42. https://doi.org/10.6269/JRT.2009.8.1.03
張新傑(Hsin-ChiehC, 張莉玉(Li-YuC, 吳佳齡(Chia-LingW, 吳雨珊(Yu-ShanW, 官世華(Shih-LfuaK, 江玲玲(Ling-LingC. 應用機械式吸吐通氣協助一位肌萎縮性脊髓側索硬化症病患清除痰液之成效. 呼吸治療. 2009;8(1):31-42. https://doi.org/10.6269/JRT.2009.8.1.03
張新傑(Hsin-Chieh Chang) ; 張莉玉(Li-Yu Chaug) ; 吳佳齡(Chia-Ling Wu) ; 吳雨珊(Yu-Shan Wu) ; 官世華(Shih-Lfua Kuan) ; 江玲玲(Ling-Ling Chiang). / 應用機械式吸吐通氣協助一位肌萎縮性脊髓側索硬化症病患清除痰液之成效. In: 呼吸治療. 2009 ; Vol. 8, No. 1. pp. 31-42.
@article{2012aefc242c4a58b8bbe6e6fc19ae38,
title = "應用機械式吸吐通氣協助一位肌萎縮性脊髓側索硬化症病患清除痰液之成效",
abstract = "神經肌肉病患因呼吸肌無力造成呼吸衰竭而使用呼吸器,其漸進肌萎縮致使部份病患成爲呼吸器依賴病患。此種病患除吸氣肌外吐氣肌亦無力,無法主動咳痰,故常需藉外力協助作咳痰動作。傳統上若只姿位引流抽痰,亦常出現嚴重低血氧及肺部塌陷,所以清痰無效是照護上主要的問題。臨床上應用機械吸吐通氣(mechanical insufflation-exsufflation: MI-E)之助咳機(cough assistmachine)於神經肌肉病患,應可有效清除痰液。 本個案是一位肌萎縮性脊髓側索硬化症(amyotrophic lateral sclerosis: ALS)病患,採用機械式吸吐通氣助咳機協助清除痰液約兩個月,明顯的改善痰液的累積。其結果描述如下:胸部X光呈現之前肺塌陷能再度擴張,且胸悶及喘現象減少,病人較能沉睡;呼吸器使用氧濃度降低,並可改成容積控制而不會不舒服。治療當中持續監測,發現使用助咳機對心跳影響不大。由痰量記錄可知治療當中皆能明顯有效清除痰液。依此個案治療成效,我們建議採用機械式吸吐通氣助咳機協助神經肌肉病患清除痰液。",
keywords = "肌萎縮性脊髓側索硬化症, 機械式吸吐通氣, 助咳機, 清除痰液, amyotrophic lateral sclerosis, mechanical insufflation-exsufflation, cough assist machine, sputum clearance",
author = "張, {新傑(Hsin-Chieh Chang)} and 張, {莉玉(Li-Yu Chaug)} and 吳, {佳齡(Chia-Ling Wu)} and 吳, {雨珊(Yu-Shan Wu)} and 官, {世華(Shih-Lfua Kuan)} and 江, {玲玲(Ling-Ling Chiang)}",
year = "2009",
doi = "10.6269/JRT.2009.8.1.03",
language = "繁體中文",
volume = "8",
pages = "31--42",
journal = "呼吸治療",
issn = "1991-2609",
publisher = "臺灣呼吸治療學會",
number = "1",

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TY - JOUR

T1 - 應用機械式吸吐通氣協助一位肌萎縮性脊髓側索硬化症病患清除痰液之成效

AU - 張, 新傑(Hsin-Chieh Chang)

AU - 張, 莉玉(Li-Yu Chaug)

AU - 吳, 佳齡(Chia-Ling Wu)

AU - 吳, 雨珊(Yu-Shan Wu)

AU - 官, 世華(Shih-Lfua Kuan)

AU - 江, 玲玲(Ling-Ling Chiang)

PY - 2009

Y1 - 2009

N2 - 神經肌肉病患因呼吸肌無力造成呼吸衰竭而使用呼吸器,其漸進肌萎縮致使部份病患成爲呼吸器依賴病患。此種病患除吸氣肌外吐氣肌亦無力,無法主動咳痰,故常需藉外力協助作咳痰動作。傳統上若只姿位引流抽痰,亦常出現嚴重低血氧及肺部塌陷,所以清痰無效是照護上主要的問題。臨床上應用機械吸吐通氣(mechanical insufflation-exsufflation: MI-E)之助咳機(cough assistmachine)於神經肌肉病患,應可有效清除痰液。 本個案是一位肌萎縮性脊髓側索硬化症(amyotrophic lateral sclerosis: ALS)病患,採用機械式吸吐通氣助咳機協助清除痰液約兩個月,明顯的改善痰液的累積。其結果描述如下:胸部X光呈現之前肺塌陷能再度擴張,且胸悶及喘現象減少,病人較能沉睡;呼吸器使用氧濃度降低,並可改成容積控制而不會不舒服。治療當中持續監測,發現使用助咳機對心跳影響不大。由痰量記錄可知治療當中皆能明顯有效清除痰液。依此個案治療成效,我們建議採用機械式吸吐通氣助咳機協助神經肌肉病患清除痰液。

AB - 神經肌肉病患因呼吸肌無力造成呼吸衰竭而使用呼吸器,其漸進肌萎縮致使部份病患成爲呼吸器依賴病患。此種病患除吸氣肌外吐氣肌亦無力,無法主動咳痰,故常需藉外力協助作咳痰動作。傳統上若只姿位引流抽痰,亦常出現嚴重低血氧及肺部塌陷,所以清痰無效是照護上主要的問題。臨床上應用機械吸吐通氣(mechanical insufflation-exsufflation: MI-E)之助咳機(cough assistmachine)於神經肌肉病患,應可有效清除痰液。 本個案是一位肌萎縮性脊髓側索硬化症(amyotrophic lateral sclerosis: ALS)病患,採用機械式吸吐通氣助咳機協助清除痰液約兩個月,明顯的改善痰液的累積。其結果描述如下:胸部X光呈現之前肺塌陷能再度擴張,且胸悶及喘現象減少,病人較能沉睡;呼吸器使用氧濃度降低,並可改成容積控制而不會不舒服。治療當中持續監測,發現使用助咳機對心跳影響不大。由痰量記錄可知治療當中皆能明顯有效清除痰液。依此個案治療成效,我們建議採用機械式吸吐通氣助咳機協助神經肌肉病患清除痰液。

KW - 肌萎縮性脊髓側索硬化症

KW - 機械式吸吐通氣

KW - 助咳機

KW - 清除痰液

KW - amyotrophic lateral sclerosis

KW - mechanical insufflation-exsufflation

KW - cough assist machine

KW - sputum clearance

U2 - 10.6269/JRT.2009.8.1.03

DO - 10.6269/JRT.2009.8.1.03

M3 - 文章

VL - 8

SP - 31

EP - 42

JO - 呼吸治療

JF - 呼吸治療

SN - 1991-2609

IS - 1

ER -