Mekanik İnsuflasyon-Eksuflasyon Cihazının Nöromusküler Hastalıkları Olan Çocuklarda Yaşam Kalitesine ve Hastane Yatışına Etkisi

Öz

Giriş: Nöromusküler hastalığı (NMH) olan olgularda en önemli morbidite ve mortalite nedeni solunumsal komplikasyonlardır. Çalışmanın amacı Mekanik İnsuflasyon-Eksuflasyon (Mİ-E) cihazı kullanan NMH’li olguların demografik verilerini ve Mİ-E cihazının yaşam kalitesine ve hastane yatışına olan etkisini incelemekti. Gereç ve Yöntemler: Aralık 2019 ve Aralık 2020 tarihleri arasında Çocuk Göğüs Hastalıkları Polikliniği’nde NMH tanısıyla takip edilen 18 yaşından küçük hastalar çalışmaya dahil edildi. En az 3 aydır Mİ-E cihazı kullanan 27 NMH ‘li hasta çalışma grubuna ve sadece manuel solunum yolu temizleme teknikleri kullanan 30 hasta kontrol grubuna alındı. Klinik ve demografik özellikleri, Mİ-E cihazı ayarları, balgam çıkarmadaki kolaylık vizüel analog skorları (BÇK) ve yaşam kalitesi skorlarıyla ilgili veriler toplandı. Mİ-E cihazını 12 aydan uzun süre kullanan 13 olgunun Mİ-E cihazı öncesi ve sonrası solunumsal nedenlerle hastaneye yatış verileri değerlendirildi. Bulgular: Mİ-E cihazı kullanımı sonrası BÇK skorları cihaz kullanımı öncesine göre istatiksel anlamlı yüksekti. Mİ-E cihazı kullanımı öncesi ve sonrası değerlendirilen olgularda hastaneye yatış sayısında ve süresinde istatistiksel anlamlı azalma vardı. Çalışma grubu içerisindeki trakeostomili spinal musküler atrofi (SMA) tanılı olguların yaşam kalitesi skorları ortalaması kontrol grubundaki trakeostomili SMA’lı olgulara göre istatistiksel anlamlı yüksek saptandı. Sonuç: Mİ-E cihazı kullanımı NMH'li hastalarda BÇK’ya, hastaneye yatış sayı ve süresine olumlu katkı sağladı ve SMA'lı hastalarda yaşam kalitesine olumlu katkıda bulundu.

Anahtar Kelimeler

• Mekanik İnsuflasyon-Eksuflasyon
• nöromusküler hastalık
• Mİ-E cihazı
• yaşam kalitesi

The Effect of a Mechanical Insufflation-Exsufflation Device on Quality of Life and Hospitalization of Children with Neuromuscular Disorders

Abstract

Background: Respiratory complications are a significant cause of morbidity and mortality in patients with neuromuscular diseases (NMD). The aim of this study was to examine the demographic data of subjects with NMD using a mechanical insufflation-exsufflation (MI-E) device and the effect of an MI-E device on quality of life (QoL) and hospitalization. Methods: The study included patients under 18 years with NMD followed up in the Pediatric Pulmonology Polyclinic between December 2019 and December 2020. Twenty-seven patients with NMD using an MI-E for at least 3 months were enrolled in the study group and 30 patients with NMD using only manuel airway clearance techniques were enrolled in the control group. Data were collected with respect to clinical and demographic characteristics, the MI-E device settings, ease of expectoration visual analogue scores (EE), and the QoL scores. Thirteen subjects, who used an MI-E device for more than 12 months, were assessed pre-and post-MI-E use hospitalization data for respiratory reasons. Results: The mean EE scores were significantly higher after MI-E device use compared to before. Among participants who were evaluated pre- and post-MI-E use there was a significant decrease in the number of hospital admissions and length of stay. The mean QoL scores of subjects diagnosed with spinal muscular atrophy (SMA) with tracheostomy in study group were determined to be significantly higher than SMA with tracheostomy in control group. Conclusions: Use of an MI-E device made a positive contribution to EE, number of hospital admissions and length of stay in patients with NMD, and it contributed positively to QoL in patients with SMA.

Keywords

• mechanical insufflation-exsufflation
• neuromuscular disorder
• MI-E device
• quality of life

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