Warning Signs of Imminent Respiratory Failure in Neurological Patients

Alejandro A. Rabinstein; Eelco F. M. Wijdicks

doi:10.1055/s-2003-40757

Seminars in Neurology, Table of Contents

Semin Neurol 2003; 23(1): 097-104
DOI: 10.1055/s-2003-40757

Warning Signs of Imminent Respiratory Failure in Neurological Patients

Alejandro A. Rabinstein, Eelco F.M. Wijdicks

Neurological-Neurosurgical ICU, Saint Mary's Hospital, and Department of Neurology, Mayo Clinic, Rochester, Minnesota

Abstract

ABSTRACT

Critically ill neurological patients often need ventilatory assistance. After acute central nervous system insults, the inability to protect the airway and impaired central respiratory drive can only be managed with endotracheal intubation and mechanical ventilation. In patients with acute or worsening neuromuscular disorders, diaphragmatic failure and pronounced bulbar weakness may necessitate intubation to assist in the work of breathing or to prevent upper airway obstruction. Simple respiratory function tests performed at the bedside should be used to monitor patients with progressive neuromuscular respiratory insufficiency. Noninvasive positive pressure ventilation plays an important role in the management of respiratory failure in patients with neuromuscular respiratory failure, and its indications may be expanded in the future.

KEYWORDS

Respiratory failure - neuromuscular - ventilation - stroke

Full Text

References

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