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Semin Neurol 2003; 23(1): 097-104
DOI: 10.1055/s-2003-40757
Copyright © 2002 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA. Tel.: +1(212) 584-4662

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
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Publication History

Publication Date:
21 July 2003 (online)

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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

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