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Perinatal spinal cord injury requiring long-term home mechanical ventilation: a report of four cases
J C Lumeng1, V S Nelson, E A Hurvitz
1Department of Pediatrics and Communicable Diseases, Mott Hospital, Ann Arbor, MI 48109-0230, USA.
Insights
Perinatal spinal cord injury outcomes are rarely studied long-term. This study shows children on home mechanical ventilation for years have improved prognoses, contrary to existing literature.
Area of Science:
- Pediatric Neurology
- Respiratory Medicine
- Rehabilitation Medicine
Background:
- Limited research exists on long-term outcomes for perinatal spinal cord injury (SCI).
- No studies specifically address long-term home mechanical ventilation (HMV) outcomes in this pediatric population.
Observation:
- Four patients with perinatal SCI utilized HMV for 6–17 years.
- Patient courses involved respiratory, neuromuscular, neuropsychological, and nutritional assessments.
Findings:
- Varied results were observed across the four patients.
- Long-term HMV in perinatal SCI appears to offer a more positive prognosis than previously suggested.
- Organized HMV programs and increased acceptance improve outcomes.
Implications:
- Current literature may underestimate the long-term prognosis for children with perinatal SCI requiring assisted ventilation.
- Advances in HMV programs enhance survival and quality of life for affected children.
- Further research is warranted to fully elucidate long-term outcomes and optimize care.
Abstract:
Although perinatal spinal cord injury has been discussed in detail in the literature with respect to aetiology and diagnosis, few studies address long-term outcome, and none address the outcome of long-term home mechanical ventilation in this population. The four patients reported here with perinatal spinal cord injury have used home mechanical ventilation for time periods ranging from 6 to 17 years, with varying results. Their courses with respect to respiratory, neuromuscular, neuropsychological, and nutritional issues are described with reference to the current literature. It is believed that, with the advent of organized home mechanical ventilation programmes and increased acceptance of this technology by the lay public and medical community, the prognosis of the child with perinatal spinal cord injury requiring assisted ventilation is much improved, and may be more positive than the literature currently suggests.