Effective Mechanical Insufflation-Exsufflation in a Patient With Difficulty in Sputum Discharge and Intensive Care Unit-Acquired Weakness: A Case Report.

有效的机械吹气 - 排痰困难和重症监护病房获得性虚弱的患者的排气 ： 一例报告。

• 发表时间: Feb 2022
• 来源期刊: Cureus
• DOI: 10.7759/cureus.21847
• PMID: 35291546
• 文章类型: Case Reports
• 作者列表: Nonoyama T,Shigemi H,Yasutake C,Matsumine A,Ishizuka T,Nonoyama T,Shigemi H,Yasutake C,Matsumine A,Ishizuka T

关键词: icu-acquired weakness; intensive care unit; mechanical insufflation-exsufflation; musculoskeletal rehabilitation; respiratory care; icu-acquired weakness; intensive care unit; mechanical insufflation-exsufflation; musculoskeletal rehabilitation; respiratory care

Abstract

Intensive care unit-acquired weakness (ICU-AW), a common complication in critically ill patients, may result in diaphragmatic dysfunction, which delays weaning from artificial ventilators. Here, we present the case of a patient with difficulty in sputum discharge due to ICU-AW. In the ICU, postural drainage sputum aspiration by bronchoscopy and squeezing were performed daily, but the patient\'s condition did not resolve. Mechanical insufflation-exsufflation (MI-E) enabled the sputum to move to the main bronchus from the peripheral bronchi, and suctioning using a bronchoscope was no longer necessary. However, the presence of sputum persisted, and MI-E was necessary after weaning, proving crucial in treating the patient with sputum discharge difficulty complicated by ICU-AW after being removed from an artificial ventilator. MI-E can be useful for patients with difficulty in sputum discharge due to ICU-AW; however, the weaning process may be prolonged in such cases.

摘要

重症监护病房获得性虚弱(ICU-AW),危重病人常见的并发症，可能会导致膈肌功能障碍,延迟了人工呼吸机的断奶时间.这里,我们介绍了一例因ICU-AW导致痰液排出困难的患者。在ICU,体位引流每天进行支气管镜吸痰和挤压，但病人的病情没有解决。机械吹气-排气（MI-E）使痰从外周支气管移动到主支气管，不再需要使用支气管镜进行抽吸。然而,痰的存在持续存在，断奶后需要MI-E,证明对于从人工呼吸机中取出后因ICU-AW并发痰液排出困难的患者的治疗至关重要。MI-E可用于因ICU-AW导致痰液排出困难的患者;然而,在这种情况下，断奶过程可能会延长。