Cuirass respirator treatment of chronic respiratory failure in scoliotic patients.
The results are reported of domiciliary cuirass respirator treatment, using tailor-made shells, in four patients with severe thoracic scoliosis. Three of the patients had suffered from poliomyelitis. All complained of increasing dyspnoea on exertion, ultimately interfering with almost every activity of daily life; three patients had severe acute respiratory failure necessitating urgent admission to the Respiratory Care Unit. Right heart failure was present in two. Two patients required mechanical treatment via an endotracheal tube. All the patients were discharged home with a cuirass respirator. Standard type shells were used initially with low efficiency due to the poor fit of the cuirass shell to the deformed thoracic cage. Tailor-made shells were constructed from polyester reinforced with glass fibre, modelled on plaster casts of the thoracic cage. Subjectively the patients improved greatly and were able to resume and increase many activities. One patient committed suicide for reasons unconnected with treatment but the other three patients have been doing well from the time the cuirass respirator treatment was started, respectively, 3, 6, and 10 years ago. This treatment seems particularly effective in younger patients with severe paralytic scoliosis and cardiorespiratory failure, although the possibility of using it in older patients suffering from scoliosis of other aetiology should certainly be explored.
D000293:Adolescent; D000328:Adult; D002908:Chronic Disease; D005260:Female; D006801:Humans; D008297:Male; D011051:Poliomyelitis / Q000150:complications; D012131:Respiratory Insufficiency / Q000209:etiology / Q000628:therapy*; D012600:Scoliosis / Q000150:complications*; D012122:Ventilators, Mechanical / Q000295:instrumentation*
Medicine (Baltimore). 1959 Sep;38:263-317
13799416
Thorax. 1965 Mar;20:175-81
14264645
Am Rev Respir Dis. 1965 Mar;91:356-62
14264783
Thorax. 1961 Sep;16:282-90
13876717
Proc R Soc Med. 1956 Oct;49(10):773-6
13379396
Am J Phys Med. 1973 Dec;52(6):277-88
4586255
Am Rev Respir Dis. 1975 Apr;111(4):389-97
235869
Q J Med. 1974 Oct;43(172):551-68
4462722
Thorax. 1973 Mar;28(2):209-13
4731116
Q J Med. 1976 Jan;45(177):87-100
1062815
J Clin Invest. 1975 Jun;55(6):1153-63
1133165