使用非侵襲性呼吸器輔助後天中樞性換氣不足病童拔管成功－病例報告

Successful Extubation in a Child with Acquired Central Hypoventilation by Using Non-Invasive Ventilator: A Case Report

陳佳雯(Jia-Wen Chen) ； 林建亨(Chien-Heng Lin) ； 陳傑賀(Chieh-Ho Chen)

《北市醫學雜誌》 17卷3期 (2020/09) Pp. 329-337

https://doi.org/10.6200/TCMJ.202009_17(3).0007

摘要

中樞性換氣不足（central hypoventilation）主要影響患者的呼吸及自律神經調節功能，病童因中樞神經系統而非呼吸系統的缺陷，導致呼吸較淺、換氣不足，進而缺氧、血中二氧化碳濃度增加。氣切造口術（tracheostomy）創造人工氣道，來滿足其換氣需求；較大的病童可運用非侵入性的方式治療，常見之治療及處理為非侵襲性雙階型正壓呼吸器（Bi－level Positive Airway Pressure），提供病童足夠的換氣量，以維持患者的生活品質。本文探討一位後天性中樞性換氣不足病童，歷經數次拔管失敗，使用非侵襲性雙階型正壓呼吸器輔助拔管成功。

關鍵字

後天性中樞性換氣不足 ； 非侵襲性雙階型正壓呼吸器 ； 氣切造口術

並列摘要

Central hypoventilation mainly affects the respiratory and autonomic neuromodulation functions of a patient. Children suffer from shallow breathing and insufficient ventilation because of the defects in the central nervous system rather than in the respiratory system, and thus cause hypoxia and hypercapnia. Tracheostomy creates artificial airways to meet ventilation needs; older children can be treated with a non-invasive manner, and the common treatment is the use of a non-invasive bi-level positive airway pressure ventilator apparatus to obtain adequate air exchange for maintaining a quality of life. This article discusses the case of a child with acquired central hypoventilation who failed several extubation attempts but succeeded with the assistance of a non-invasive bi-level positive airway pressure ventilator.

並列關鍵字

acquired central hypoventilation ； non-invasive bi-level positive airway pressure ventilator (BiPAP) ； tracheostomy