[Clinical problems of home mechanical ventilation management for neuromuscular disorders]

Medical management is important for home mechanical ventilation of neuromuscular disorders. We report some problems experienced with five patients and methods to improve the care. The problems were inadequate suction of sputa, sialorrhea, underestimation of patients' symptoms and signs and excessive physical and psychological burden on patients and their families. Mechanical in-exsufflator, transdermal scopolamine and the transmission of the percutaneous oxygen saturation figures from patients' home to our hospital were effective. These management is outside the health insurance system. The Ministry of Health and Welfare must look into these issues immediately. We instructed volunteers involved in medical care for patients' family to take sufficient rest. However, the repletion of public supporters for medical home care might be warranted.