Noninvasive Options for Ventilatory Support of the Traumatic High Level Quadriplegic Patient: Results (5)

In: Pulmonary function

8 Jan 2013

Comparison of patient mortality using NVA with those continuing tracheostomy IPPV was difficult. Thirty-one of the initial 80 patients were weaned (27 from tracheostomy IPPV, four from NVA). Seven patients combined the use of NVA and tracheostomy IPPV including one patient who died suddenly after three years of ventilatory support. An additional seven patients on NVA and three patients on tracheostomy IPPV required aid less than 12-h a day with only one of the latter patients dying for unknown reasons at age 64 after 12 years of overnight tracheostomy IPPV. For only seven patients was NVA the definitive method of 24-h long-term ventilatory support. buy ortho tri-cyclen

These patients had a mean age at onset of injury of 25.1 ± 12.1 years. They used 24-h NVA for 12.4 ± 6.3 years. Two of these patients died. One patient died from septicemia associated with massive decubiti following eight years of NVA including seven years of dependence on mouth IPPV 24-h a day. The other patient died from seizure-induced apnea while on mouth IPPV after five years of NVA. The 25 patients who continued 24-h tracheostomy IPPV had a mean age of 30.2 ±20 years at onset of injury. They used 24-h tracheostomy IPPV for a mean of 7.1 ±5.1 years. Five of these patients are currently lost to follow-up. Ten of the remaining 20 patients died after 3.8 ±2.8 years of ventilatory support. Their deaths were associated with pneumonia in four cases, cancer in two cases, accidental tracheostomy disconnection in two cases, aspiration from tracheal hemorrhage, ventilator malfunction, and unknown etiology in one case each.

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