呼吸器疾患ジャーナル

抽象的な

A Thorough Analysis and Advice from Experts for Respiratory Care in Familial Dysautonomia

Horacio Kaufmann

Background: Domestic dysautonomia (Riley- Day pattern, heritable sensitive autonomic neuropathy type- III) is a rare inheritable complaint caused by disabled development of sensitive and sensational autonomic jitters. As a consequence, cases develop neurogenic dysphagia with frequent aspiration, habitual lung complaint, and Chemoreflex failure leading to severe sleep disordered breathing. The purpose of these guidelines is to give recommendations for the opinion and treatment of respiratory diseases in domestic dysautonomia.

Method: We performed a methodical review to epitomize the substantiation related to our questions. When substantiation wasn't sufficient, we used data from the New York University Familial Dysautonomia Patient Registry, a database containing ongoing prospective comprehensive clinical data from 670 cases. The substantiation was epitomized and bandied by a multidisciplinary panel of experts. Substantiation- grounded and expert recommendations were also formulated, written, and graded using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) system.

Results:Recommendations were formulated for or against specific individual tests and clinical interventions. Radiological evaluation, dysphagia evaluation, gastroesophageal evaluation, bronchoscopy and bronchoalveolar lavage, pulmonary function tests, laryngoscopy, and polysomnography were some of the specific tests that were examined. Clinical interventions and curatives reviewed included forestallment and operation of aspiration, airway mucus concurrence and casket physical remedy, respiratory virus infections, high altitude or air travel precautions, non-invasive ventilation during sleep, antibiotic and steroid treatment, oxygen treatment, gastrostomy tube installation, Nissen fundoplication surgery, scoliosis surgery, tracheostomy, and lung lobectomy are just a few of the treatments available.

Conclusions: Expert recommendations for the opinion and operation of respiratory complaint in cases with domestic dysautonomia are handed. Frequent reassessment and updating will be demanded.