Rehabilitation of the patient with long-term respiratory paralysis.

Abstract

Long-term respiratory paralysis creates problems of rehabilitation. Experiences of a respiratory and rehabilitation center of 30 beds are here analyzed. Twenty beds were reserved for patients with chronic respiratory paralysis. In a five-year period there have been 375 admissions, including readmissions for rechecks, and the 100 patients with the most marked involvement of respiratory and other neuromuscular mechanisms were selected for special study. Such patients require continued care equivalent to that given to the acutely ill patient, and 64 of them arrived in tank respirators. The average period of rehabilitation was 8 months, but some required more than 12. The most frequent complications were renal calculi (detected in 38 patients) and atelectasis (in 36). The best results were obtained when the process of weaning from the respirator was concomitant with rehabilitation instead of taking precedence over it. Although 98% of the patients were freed from the tank respirator, only 16% were freed from all respiratory aid. Five patients died at the center, but 80 were able to return to private home care, and 44 were cared for completely by the family. Sixteen patients who were housewives continued as the dominant figures in their home situation despite continued dependence on respiratory aids. A program of comprehensive care and rehabilitation for this type of patient is economically desirable and has incalculable human values.