학술논문

Successful Transition to Home Medical Care by Combination of High Flow Nasal Cannula and Multidisciplinary Team Approach in a Patient with Trisomy 21 / 高流量鼻カニューラ酸素療法と多職種連携により,安定した在宅療養が可能となった21トリソミーの1例
Document Type
Journal Article
Source
東京女子医科大学雑誌 / Journal of Tokyo Women's Medical University. 2021, 91(2):148
Subject
high-flow nasal cannula (HFNC)
home medical care
multidisciplinary cooperation
pharyngomalacia
trisomy 21
Language
Japanese
ISSN
0040-9022
2432-6178
Abstract
We experienced a boy aged 1 year and 8 months with trisomy 21 who could receive home medical care through high-flow nasal cannula (HFNC) and multidisciplinary collaboration. At age 8 months, he underwent the first emergency admission due to acute respiratory infection. He was originally pointed out about his stridor. At age 11 months, he was diagnosed with pharyngomalacia and laryngotracheal deformities by bronchoscopy. We administered noninvasive positive pressure ventilation (NPPV); however, he required six emergency admissions due to respiratory insufficiency by the age of 1 year and 8 months. He could not tolerate NPPV, and his parents experienced difficulty and fatigue in home medical care. Therefore, we changed NPPV to HFNC, after which he became acceptable to the oxygen therapy, and a relaxing positioning administered by the physiotherapist was also useful for reducing his breathing effort. Smooth transition to home medical care can also be achieved by the cooperation of multiple professionals, including visiting physicians, nurses, and medical social workers.