In the beginning, patients with neuromuscular disease often do not show symptoms of difficulty in breathing caused by oxygen deficiency, such as patients with general lung disease. Instead, some of the most common symptoms include fatigue, sleep apnea, nightmares and morning headaches. Additionally, anxiety, confusion, a loss of appetite and weight loss can be some of the symptoms associated with respiratory failure. Difficulty with coughing and talking means that respiratory muscles are weakening and that a patient is in a condition where it is difficult for him or her to expectorate sputum. If any of these symptoms appear in a patient, he or she must go through thorough pulmonary functional tests and receive treatment.
There are two different ways to connect the ventilator to patient - one is an invasive method, which is done via a tracheostomy tube, and the other one is a noninvasive method that uses a mask or mouthpiece. Unlike medication, a ventilator cannot be prescribed by a physician and used by patients. Patients must be hospitalized for at least 2 to 3 days since their breathing conditions must be thoroughly evaluated and determine optimal ventilator setting for each patient.
1) Noninvasive Treatment: Patients, after a tracheostomy undergo speaking and eating difficulties, and the procedure itself can cause a variety of side effects and complications that include increased amounts of secretion and can be a source of infection of the respiratory system. On the other hand, this method where a patient uses a mask without undergoing a tracheostomy, when compared with a patient who uses a ventilator after receiving a tracheostomy, lowers the incidence rate of pneumonia, lowers the number and period of hospitalization days due to complications of the respiratory system, reduces the emotional burden on a patient, strives for greater nursing efficiency of a caregiver, and improves the level of a patients’ satisfaction in their lives. One effect is that this is only applicable for patients who can pronounce speech correctly and avoid choking while eating.
2) Invasive Treatment: A tracheostomy is recommended for patients who are unable to expectorate sputum due to weakened coughing ability and have difficulties coughing as they frequently choke on. A ventilator can be used without a tracheostomy if the test result shows the patient’s coughing ability can be maintained at 160 liters per minute. However, this can be only confirmed when a medical team performs an examination. In general, a ventilator can be used without tracheostomy if the patient can speak fairly well and swallow food. A tracheostomy is a simple operation and it only takes about 2 days for a patient to fully recover from the procedure. There are many advantages to performing this procedure for those who have severe symptoms. In the worst-case scenario, brain damage may occur in patients if they swallow the wrong way or the airway becomes obstructed by sputum and treatment is delayed since oxygen is not delivered to the brain due to respiratory failure.