Conventional Respiratory Management of Spinal Cord Injury

Bach, John R.; Burke, Lindsay; Chiou, Michael

doi:10.1016/j.pmr.2020.04.004

Cited by 12 publications

(6 citation statements)

References 58 publications

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“…However, it is noteworthy that the tracheostomy state can significantly impact a patient's respiratory function, especially if adequate warming and humidification are not provided. Furthermore, prolonged tracheostomy can affect swallowing function and contribute to airway narrowing and softening, inflammation, excessive coughing, and granulation tissue proliferation, ultimately increasing the risk of mortality (16).Moreover, the successful decannulation and restoration of the patient's original physiological state is a crucial milestone in the recovery process for patients with SCI who have undergone tracheotomy (11).Therefore, it is essential to understand the factors that influence tracheotomy and successful decannulation in this population. Numerous studies have been conducted on the tracheotomy rates for CSCI (17,18), however, research on decannulation of CSCI is relatively scarce (11).…”

Section: Discussionmentioning

confidence: 99%

Long-term trends and risk factors of tracheostomy and decannulation in patients with cervical spinal cord Injury

Gao,

Liu

et al. 2024

Spinal Cord

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Study design： Retrospective study.Objectives： To investigate the risk factors of tracheostomy and decannulation after cervical spinal cord injury (CSCI) and their epidemiological changes over the past 8 years in Beijing Bo'ai Hospital, China Rehabilitation Research Center (CRRC), China.Setting： Beijing Bo'ai Hospital, CRRC.Methods：We reviewed 8 years of patient data (2013.1.1 to 2020.12.31) at CRRC, focusing on those hospitalized and diagnosed with CSCI. We analyzed changes in demographic and clinical data's trends. Logistic regression analysis was used to determine factors impacting tracheostomy and decannulation.Results：Finally, 1641 CSCI patients met the inclusion criteria. Over the past 8 years, the proportion of tracheostomized patients with CSCI was 16.3%, and the proportion of successfully decannulated of tracheostomized patients with TCSCI was 77.9%.We found that Traumatic (OR=1.8, 95%CI= 1.06,3.22;p=0.046),Motor level of injury (C5-C8) (OR=0.32, 95%CI= -1.91,-0.34;p=0.005), AIS=A/B/C (OR=22. 7/11.1/4.2, 95%CI= 12.16,42.26/5.74,21.56/2.23,7.89;p<0.001/ p<0.001/ p<0.001), Age>56 (OR=1.6, 95%CI= 1.04,2.32;p=0.031) were the risk factors for tracheostomy. By analyzing the risk factors of decannulation in tracheostomized patients with TCSCI through multivariable logistic regression, statistically significant differences were found in age＞45(OR=4.

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Section: Discussionmentioning

confidence: 99%

Long-term trends and risk factors of tracheostomy and decannulation in patients with cervical spinal cord Injury

Gao,

Liu

et al. 2024

Spinal Cord

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“…The morbimortality of SCI patients with respiratory complications is frequently associated with ineffective cough flows [ 6 ]. There is some controversy regarding the ideal ventilation weaning protocol and tracheostomy indication in patients with compromised secretion mobilization.…”

Section: Discussionmentioning

confidence: 99%

“…However, the endotracheal tube interferes with bronchial hygiene and the tracheostomy increases upper airway complications. Some authors advocate that in SCI patients that do not pass the ventilator weaning criteria, it is easier and better to extubate and transition them to non-invasive ventilation and MIE than to do an elective tracheostomy [ 6 ].…”

Section: Discussionmentioning

confidence: 99%

Good Bronchial Hygiene Reaches the Left Lung: Successful Extubation in a Tetraplegic Patient With Spinal Cord Injury

Pascoal¹,

Lourenço²,

Pires³

et al. 2022

Cureus

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Ineffective coughing affects bronchial hygiene and is a major contributor to respiratory complications after spinal cord injury (SCI). Mechanical insufflation-exsufflation (MIE) therapy increases inspiratory and expiratory flow to assist bronchial secretions clearance.We present a case of a 67-year-old cervical SCI patient with lung infection and partial atelectasis in the lower left lung, associated with difficult ventilator weaning. About one day after the beginning of MIE therapy, an improvement of the atelectasis was verified. The patient was extubated six days after the beginning of bronchial hygiene with MIE therapy and safely transitioned to non-invasive ventilatory support.

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“…The spinal cord is not only a sensory and motor pathway but also involves the respiratory neural network. Particularly, the diaphragm, which is the major inspiratory muscle, is innervated by levels C3 through C5, and lesions above C3 can lead to an interruption of spontaneous breathing 4,5 . Respiratory dysfunction is a debated issue in patients with spinal cord injury, especially when involving upper cervical levels.…”

mentioning

confidence: 99%

“…Respiratory dysfunction is a debated issue in patients with spinal cord injury, especially when involving upper cervical levels. Therefore, in this field, there has been extensive research on the pathophysiology, clinical management, and rehabilitation for respiratory dysfunction 4,5 .…”

mentioning

confidence: 99%

Spontaneous Cervical Epidural Hematoma Presenting with Respiratory Failure

Ohno,

Fujishiro,

Hayama

et al. 2023

JBJS Case Connector

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Case: A 62-year-old woman who had an unremarkable medical history presented with sudden headache and neck pain. After the presentation, complete quadriplegia and respiratory arrest developed, and the patient was urgently intubated. Magnetic resonance imaging revealed an extensive epidural hematoma (EH), and emergency hematoma evacuation was performed. At the 1-year follow-up visit, the patient had no motor deficits. Conclusion: We reported a case of spontaneous cervical EH presenting with respiratory failure that was successfully treated with surgical management. Literature review has shown that the surgical outcome is very poor; nevertheless, prompt surgical decompression of the spinal cord can minimize neurological sequelae.

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Conventional Respiratory Management of Spinal Cord Injury

Cited by 12 publications

References 58 publications

Long-term trends and risk factors of tracheostomy and decannulation in patients with cervical spinal cord Injury

Long-term trends and risk factors of tracheostomy and decannulation in patients with cervical spinal cord Injury

Good Bronchial Hygiene Reaches the Left Lung: Successful Extubation in a Tetraplegic Patient With Spinal Cord Injury

Spontaneous Cervical Epidural Hematoma Presenting with Respiratory Failure

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