Kyphoscoliosis and respiratory failure. A patient treated with assisted ventilation for 27 years

A 62-year-old woman had had kyphoscoliosis since age 12 years. Respiratory failure developed at age 35 years following a respiratory infection. A tracheostomy was done and she required assisted ventilation using a respiratory (Bird). Many attempts at weaning her from the ventilator were unsuccessful. She has remained dependent on assisted ventilation for more than 27 years but has had a relatively comfortable and meaningful life. In 1983, a left pleuroscopy was done related to recurrent pneumothorax and numerous small bullae were seen on the lung surface. Recent investigation using computed tomographic scanning has shown patchy areas of emphysema in both lungs. Emphysema is not a feature of kyphoscoliosis and it is suggested that intermittent positive pressure applied to the lung over long duration may cause the lung destruction of emphysema.