Abstract
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.
Keywords
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References
- Ethical attitudes of Japanese physicians regarding life-sustaining treatment for children with severe neurological disabilities.Brain Dev. 2000; 22: 113-117
- Long-term ventilator-assisted children in Japan: a national survey.Acta Paediatr Jpn. 1996; 38: 137-142
- Chronic ventilator-assisted children in university hospitals in Japan.Acta Paediatr Jpn. 1993; 35: 332-335
- Long-term ventilation in children with severe central nervous system impairment.Semin Neurol. 1997; 17: 239-248
- American Academy of Pediatrics. Guidelines of forgoing life-sustaining medical treatment.Pediatrics. 1994; 93: 532-536
- Ethics and the care of critically ill infants and children.Pediatrics. 1996; 98: 149-152
- Life-sustaining mechanical ventilation care for children with progressive or degenerative brain disorders.No to Hattatsu. 2001; 33 (In Japanese): 253-258
- A severely brain-damaged case of 3-hydroxyisobutyric aciduria.Brain Dev. 2001; 23: 243-245
- Apneustic breathing in children with brainstem damage due to hypoxic–ischemic encephalopathy.Dev Med Child Neurol. 1999; 41: 560-567
- Home care for life-supported persons: an approach to program development.J Pediatr. 1984; 104: 785-795
- Current status of long term ventilation of children in the United Kingdom: questionnaire survey.Br Med J. 1999; 318: 295-299
- Home treatment for chronic respiratory insufficiency: the situation in Europe in 1992. The European Working Group on Home Treatment for Respiratory Insufficiency.Eur Respir J. 1994; 7: 1721-1726
- Chronic mechanical ventilation-dependent children in Canada.Paediatr Child Health. 1996; 1: 111-116
- Long-term mechanical ventilation of patients in Australia.Med J Aust. 1989; 150: 3-6
- Home mechanical ventilation of children.Dev Med Child Neurol. 1996; 38: 704-715
- End of life care in Duchenne muscular dystrophy.Pediatr Neurol. 1993; 9: 165-177
Article Info
Publication History
Accepted:
August 17,
2001
Received in revised form:
August 1,
2001
Received:
May 14,
2001
Identification
Copyright
© 2001 Elsevier Science B.V. Published by Elsevier Inc. All rights reserved.
