The neurological patient that develops respiratory failure usually has obvious neurological disease. Intubation is always indicated in respiratory failure associated with decreased ventilation. Once the patient has been stabilized, the lesion must be localized. This will help the clinician establish a list of differential diagnoses and the general prognosis for the patient. If the disease is treatable owner commitment and expectations need to be explored as these cases can require long-term intensive management.
|Brain||Sedative drugs (opiods), trauma, edema, neoplasia herniation, thromboemboli, hypoxia, hypoglycemia, encephalopathy|
|Cervical cord||Trauma, disc,fractures, polyradiculoneuritis, myelography, laminectomy|
|Neuromuscular||Myasthenia gravis, polyneuropathy, botulism|
Intubating the patient and initiating ventilation is the first step. The next stage is planning the diagnostic work up and treatment procedures. This helps establish whether a resolution of the underlying disease process is feasible and may aid in providing owners with an estimated time for successful weaning from the ventilator.