High-Frequency Chest Wall Oscillation May Facilitate Extubation in Patients with Hypoxic Encephalopathy: A Case Report

使用高頻胸廓震動系統可幫助缺氧性腦病變患者拔管─病例報告

陳俊榮(Jiun-Rung Chen) ； 吳碧珠(Pi-Chu Wu) ； 陳昭瑢(Chao-Jung Chen) ； 鄭雅華(Ya-Hua Cheng) ； 許正園(Jeng-Yuan Hsu) ； 吳杰亮(Chieh-Liang Wu)

《胸腔醫學》 27卷2期 (2012/04) Pp. 105-111

https://doi.org/10.29806/TM.201204.0006

摘要

清除呼吸道分泌物能力不佳時可導致多種肺部併發症，如肺炎，肺膨脹不全，窒息，呼吸衰竭，甚至死亡。高頻胸廓震動系統（high-frequency chest wall oscillation）提供了安全，有效，且耐受性良好的治療，以除去過多的呼吸道分泌物。我們描述了一個患有缺氧性腦病變的68歲男子，藉由高頻胸廓震動系統促進呼吸道分泌物排除並避免肺塌陷的發生，幫助病人成功拔管。高頻胸廓震動系統在拔管5天後停用。不幸地，在拔管二個星期後，他因為疑似呼吸道分泌物增加造成低血氧而死亡。對於缺氧性腦病變患者合併咳嗽能力不佳，高頻胸廓震動系統對拔管可能有短期的效果。然而，對這類病人使用高頻胸廓震動系統的長期效益及安全性仍需進一步研究。（胸腔醫學2012；27：105－111）

關鍵字

高頻胸廓震動系統 ； 缺氧性腦病變 ； 拔管

並列摘要

Impaired airway clearance leads to pulmonary complications, such as pneumonia, atelectasis, asphyxia, respiratory failure, and death. High-frequency chest wall oscillation (HFCWO) provides a safe, effective and well-tolerated therapy for removal of excessive airway secretions. We describe a 68-year-old man with hypoxic encephalopathy who was extubated successfully with the assistance of HFCWO which improved airway secretion clearance and prevented atelectasis. HFCWO therapy was stopped 5 days after extubation. Unfortunately, the patient died of hypoxemia as a result of suspected retention of airway secretions 2 weeks after extubation. HFCWO may be of use in the short term for facilitating extubation in patients with hypoxic encephalopathy complicated with ineffective cough. However, the long-term effect and safety of HFCWO with these patients should be further investigated. (Thorac Med 2012; 27: 105-111)

並列關鍵字

high-frequency chest wall oscillation ； hypoxic encephalopathy ； extubation