Introduction Spinal cord injury (SCI) is a cause of significant psychosocial stress not only to the individual with SCI but also to their family. This is compounded when an individual with a new SCI has premorbid behavioral and medical conditions. For individuals requiring long term positive pressure ventilation, transition to noninvasive ventilation (NIV) can improve the long term outcome and improve quality of life. Case presentation This case report describes a teenage boy with premorbid autism spectrum disorder who incurred an acute SCI and developed chronic respiratory failure. He was admitted to acute inpatient rehabilitation with tracheostomy and ventilator dependence. Using an interdisciplinary team approach with in vivo desensitization behavioral interventions, he was successfully weaned off mechanical ventilation, his tracheostomy tube was removed, and he was transitioned to NIV. Discussion This case describes a medically complex adolescent who was successfully transitioned to NIV through behavioral desensitization using a team approach. This is noteworthy given the magnitude of behaviors demonstrated prior to his desensitization protocol. This case demonstrates how serious behavioral barriers to NIV can be overcome using desensitization and strategic behavioral reinforcement techniques.

中文翻译：

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病例报告：患有自闭症谱系障碍和新发脊髓损伤的青少年的呼吸机脱机、气管切开拔管和无创通气。

简介 脊髓损伤 (SCI) 不仅会给 SCI 患者带来严重的社会心理压力，也会给他们的家人带来巨大的社会心理压力。当患有新 SCI 的个体患有病前行为和医疗状况时，情况会变得更加复杂。对于需要长期正压通气的个体，过渡到无创通气 (NIV) 可以改善长期结果并提高生活质量。病例介绍 本病例报告描述了一名患有病前自闭症谱系障碍的十几岁男孩，他发生了急性脊髓损伤，并发展为慢性呼吸衰竭。他因气管切开术和呼吸机依赖而被送入急性住院康复治疗。通过跨学科团队方法和体内脱敏行为干预，他成功脱离机械通气，拔除气管切开插管，并转为 NIV。讨论 该病例描述了一位患有复杂医学的青少年，他使用团队方法通过行为脱敏成功过渡到 NIV。考虑到他的脱敏方案之前所表现出的行为规模，这一点值得注意。该案例展示了如何使用脱敏和策略性行为强化技术来克服 NIV 的严重行为障碍。