Case Reports
Respiratory Muscle Aids During an Episode of Aspiration in a Patient With Duchenne Muscular Dystrophy
E. Servera
, J. Sancho, J. Franco, P. Vergara, A. Catalá, M.J. Zafra
Corresponding author
Servicio de Neumología, Hospital Clínico Universitario de Valencia, Universidad de Valencia, Valencia, Spain
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"apellidos" => "Servera" "email" => array:1 [ 0 => "emilio.Servera@uv.es" ] "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor1" ] ] ] 1 => array:2 [ "nombre" => "J." "apellidos" => "Sancho" ] 2 => array:2 [ "nombre" => "J." "apellidos" => "Franco" ] 3 => array:2 [ "nombre" => "P." "apellidos" => "Vergara" ] 4 => array:2 [ "nombre" => "A." "apellidos" => "Catalá" ] 5 => array:2 [ "nombre" => "M.J." "apellidos" => "Zafra" ] ] "afiliaciones" => array:1 [ 0 => array:1 [ "entidad" => "Servicio de Neumología, Hospital Clínico Universitario de Valencia, Universidad de Valencia, Valencia, Spain" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor1" "etiqueta" => "*" "correspondencia" => "Correspondence: Dr. E. Servera. Blasco Ibáñez, 84. 4601 Valencia. España" ] ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2004-11-27" "fechaAceptado" => "2005-04-04" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Key Words" "identificador" => "xpalclavsec154161" "palabras" => array:5 [ 0 => "Neuromuscular diseases" 1 => "Noninvasive ventilation" 2 => "Assisted cough" 3 => "Fiberoptic bronchoscopy" 4 => "Aspiration" ] ] ] "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec154162" "palabras" => array:5 [ 0 => "Enfermedades neuromusculares" 1 => "Ventilación no invasiva" 2 => "Tos asistida" 3 => "Fibrobroncoscopia" 4 => "Aspiración" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:1 [ "resumen" => "<p class="elsevierStyleSimplePara elsevierViewall">We report the case of a Duchenne muscular dystrophy patient with good bulbar function but severely decreased forced vital capacity (9%) and spontaneous peak cough flow (PCF) (2.35 L/s). The patient needed continuous noninvasive ventilation (NIV) consisting of a volumetric ventilator with a nighttime nasal mask and a daytime mouthpiece. He also required application of manually assisted coughing techniques by insufflation with a resuscitation bag and chest thrust (manually assisted PCF after maximum insufflation capacity of 4.33 L/s). An episode of serious food aspiration was resolved by his main caregiver through NIV and manually assisted coughing. Bronchoscopy under sedation using NIV with a lip seal connection to his volumetric ventilator later revealed that no material remained. This case exemplifies the potential role of skilled respiratory management in some neuromuscular diseases.</p>" ] "es" => array:1 [ "resumen" => "<p class="elsevierStyleSimplePara elsevierViewall">Presentamos el caso de un enfermo afectado de distrofia muscular de Duchenne con buena función bulbar, pero con disminución importante de la capacidad vital forzada (9%) y del pico de flujo de tos espontaneo (2,35 l/s) que le obligaba a mantener ventilación no invasiva (VNI) continua (ventilador volumétrico, mascarilla nasal nocturna y pieza bucal en vigilia) y a utilizar ayudas manuales para la tos mediante insuflaciones con ambú y compresión torácica espiratoria (pico de flujo de tos asistida tras máxima capacidad de insuflación de 4,33 l/s). El paciente presentó una aspiración importante de material digestivo que se resolvió gracias a la asociación de las ayudas manuales para la tos proporcionadas por su cuidadora principal y a la VNI. En un segundo momento, la VNI con una boquilla sellada como conexión a un ventilador volumétrico permitió realizar una broncoscopia bajo sedación, en la que se comprobó que no había material retenido. Este caso es un ejemplo de la utilidad potencial del manejo cualificado de los problemas respiratorios en algunas enfermedades neuromusculares.</p>" ] ] "bibliografia" => array:2 [ "titulo" => "REFERENCES" "seccion" => array:1 [ 0 => array:1 [ "bibliografiaReferencia" => array:15 [ 0 => array:3 [ "identificador" => "bib1" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Natural history of amyotrophic lateral sclerosis in a database population. 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| 2020 May | 17 | 14 | 31 |
| 2020 April | 16 | 17 | 33 |
| 2020 March | 11 | 20 | 31 |
| 2020 February | 12 | 22 | 34 |
| 2020 January | 14 | 16 | 30 |
| 2019 December | 12 | 19 | 31 |
| 2019 November | 8 | 15 | 23 |
| 2019 October | 3 | 8 | 11 |
| 2019 September | 7 | 14 | 21 |
| 2019 August | 8 | 8 | 16 |
| 2019 July | 15 | 14 | 29 |
| 2019 June | 9 | 7 | 16 |
| 2019 May | 10 | 18 | 28 |
| 2019 April | 11 | 24 | 35 |
| 2019 March | 8 | 24 | 32 |
| 2019 February | 12 | 16 | 28 |
| 2019 January | 6 | 9 | 15 |
| 2018 December | 6 | 18 | 24 |
| 2018 November | 20 | 10 | 30 |
| 2018 October | 13 | 14 | 27 |
| 2018 September | 9 | 16 | 25 |
| 2018 May | 4 | 0 | 4 |
| 2018 April | 8 | 10 | 18 |
| 2018 March | 4 | 6 | 10 |
| 2018 February | 4 | 6 | 10 |
| 2018 January | 7 | 10 | 17 |
| 2017 December | 1 | 6 | 7 |
| 2017 November | 1 | 8 | 9 |
| 2017 October | 8 | 9 | 17 |
| 2017 September | 4 | 13 | 17 |
| 2017 August | 7 | 11 | 18 |
| 2017 July | 1 | 1 | 2 |
| 2017 June | 8 | 15 | 23 |
| 2017 May | 7 | 10 | 17 |
| 2017 April | 3 | 3 | 6 |
| 2017 March | 2 | 6 | 8 |
| 2017 February | 1 | 2 | 3 |
| 2017 January | 1 | 4 | 5 |
| 2016 December | 6 | 10 | 16 |
| 2016 November | 4 | 4 | 8 |
| 2016 October | 8 | 9 | 17 |
| 2016 September | 10 | 12 | 22 |
| 2016 August | 9 | 3 | 12 |
| 2016 July | 4 | 3 | 7 |
| 2016 March | 1 | 0 | 1 |
| 2016 February | 1 | 0 | 1 |
| 2015 December | 2 | 0 | 2 |
| 2015 October | 59 | 18 | 77 |
| 2015 September | 44 | 9 | 53 |
| 2015 August | 52 | 8 | 60 |
| 2015 July | 74 | 9 | 83 |
| 2015 June | 39 | 8 | 47 |
| 2015 May | 50 | 5 | 55 |
| 2015 April | 47 | 11 | 58 |
| 2015 March | 40 | 5 | 45 |
| 2015 February | 59 | 7 | 66 |
| 2015 January | 37 | 9 | 46 |
| 2014 December | 65 | 2 | 67 |
| 2014 November | 50 | 3 | 53 |
| 2014 October | 113 | 14 | 127 |
| 2014 September | 90 | 11 | 101 |
| 2014 August | 97 | 5 | 102 |
| 2014 July | 172 | 12 | 184 |
| 2014 June | 98 | 9 | 107 |
| 2014 May | 84 | 14 | 98 |
| 2014 April | 82 | 3 | 85 |
| 2014 March | 92 | 12 | 104 |
| 2014 February | 59 | 11 | 70 |
| 2014 January | 41 | 12 | 53 |
| 2013 December | 44 | 12 | 56 |
| 2013 November | 54 | 4 | 58 |
| 2013 October | 59 | 13 | 72 |
| 2013 September | 50 | 8 | 58 |
| 2013 August | 57 | 12 | 69 |
| 2013 July | 66 | 13 | 79 |
| 2013 June | 59 | 9 | 68 |
| 2013 May | 50 | 5 | 55 |
| 2013 April | 37 | 10 | 47 |
| 2013 March | 8 | 1 | 9 |
Show all
