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KMID : 0828520120160030162
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Journal of the Korean Geriatrics Society
2012 Volume.16 No. 3 p.162 ~ p.166
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Amyotrophic Lateral Sclerosis Identified by Failure to Wean From Mechanical Ventilation
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Park Ji-Hoon
Kim Bo-Sang
Byun Young-Jae
Jeong Hae-Ryong
Kim Sang-Heon
Kim Tae-Hyung
Sohn Jang-Won
Shin Dong-Ho
Park Sung-Soo
Yoon Ho-Joo
Kwak Hyun-Jung
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Abstract
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In most cases of amyotrophic lateral sclerosis (ALS), Respiratory muscle involvement is a late complication. Only 2.7% of ALS patients presenting with their first clinical symptoms in the extremities also experience respiratory symptoms. We report a case of an 81-year-old man with ALS, diagnosed by an unexplained failure to wean from mechanical ventilation. The patient presented with acute respiratory failure, tachypnea and respiratory acidosis. CT of the chest showed large amounts of sputum in the trachea. An endotracheal tube was inserted, and the patient was placed on volume-controlled ventilation. However, in the course of recovery, he could not be weaned from mechanical ventilation, despite the absence of cardiopulmonary impairment. Having considered other causes of respiratory failure, we diagnosed ALS after a physical and neurologic examination and electrodiagnostic testing.
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KEYWORD
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Amyotrophic lateral sclerosis, Lou Gehrig’s disease, Respiratory failure, Weaning failure
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