Extubation of a patient with spinal muscular atrophy type 1 in a public hospital in the province of Córdoba: a case report
Abstract
Introduction: In children with spinal muscular atrophy (SMA) type 1, only a small percentage of conventional extubations are successful. Specific protocols for this population are scarce, and even fewer have shown favorable outcomes. The objective of this study is to report a case of successful extubation in a patient with SMA type 1
treated in a public hospital in the province of Córdoba.
Case presentation: A two-month-old girl diagnosed with SMA type 1A without disease-modifying treatment was admitted to the pediatric intensive care unit due to acute respiratory failure and required invasive mechanical ventilation. Mechanical cough assistance was administered every 2–3 hours, together with lung volume recruitment
using a manual resuscitation bag. No spontaneous breathing trial was performed prior to extubation. Extubation was successfully achieved on day 3, with elective post-extubation noninvasive ventilatory support.
Conclusion: The extubation process of a patient with SMA type 1 was described. The implementation of noninvasive
ventilatory support combined with cough facilitation techniques before and after extubation was essential to achieve a successful outcome.
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