Predictors of the necessity for early tracheostomy in patients with acute cervical spinal cord injury: a 15-year experience

Jones, Edward L.; Burlew, Clay Cothren; Johnson, Jeffrey L.; Kornblith, Lucy Z.; Biffl, Walter L.; Stovall, Robert T.; Pieracci, Fredric M.; Stahel, Philip F.; Moore, Ernest E.

doi:10.1016/j.amjsurg.2014.07.016

Cited by 30 publications

(18 citation statements)

References 21 publications

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“…As for the severity of the spinal cord injury, the available literature considered this factor to be directly related to the risk of respiratory failure, and, therefore, of the need for mechanical ventilation [17][18][19]. In our study, 73.8% of patients with ASIA grade A required MV, which is a similar figure to that reported in other series (90% Jones et al 2015; 74% Velmahos et al 2003; 77.1% Aarabi et al 2012;) [9,15,16]. The spinal cord segments C3-C4-C5 are responsible for innervating the diaphragm, hence, patients with complete spinal cord injuries according to the ASIA classification and with neurological levels above C4, would have an impaired diaphragmatic function and would usually need immediate ventilatory support.…”

Section: Discussionsupporting

confidence: 85%

“…The spinal cord segments C3-C4-C5 are responsible for innervating the diaphragm, hence, patients with complete spinal cord injuries according to the ASIA classification and with neurological levels above C4, would have an impaired diaphragmatic function and would usually need immediate ventilatory support. Thus, traditionally, the affected neurological level in cases of complete CSCI has been considered a risk factor of the need for MV [3,11,14,15,20]. However, in our study, this level was not a predictive factor of the need for MV.…”

Section: Discussioncontrasting

confidence: 71%

“…Traditionally, the need for invasive ventilatory assistance has been associated with the level and extent of the spinal cord injury [3,9,15]. In our study, a univariate analysis proved that the following factors were related to the need for MV: gender, age, ASIA grade, existence of associated injuries, AMS and ISS.…”

Section: Discussionsupporting

confidence: 54%

“…In our study, 41.1% of patients with an acute cervical spinal cord injury required MV. Other authors have published higher percentages: Claxton et al 57%, Jones et al 57.6% [14,15].…”

Section: Discussionmentioning

confidence: 89%

“…In some studies, the existence of concomitant injuries to the SCI was associated with a greater risk of the need for a tracheostomy or of respiratory complications [4,21]. For example, according to Jones et al and to Branco et al an ISS ≥ 25 and ≥ 16, respectively, in incomplete lesions, is a risk factor of the need for a tracheostomy [15,22].…”

Section: Discussionmentioning

confidence: 99%

See 4 more Smart Citations

Risks factors of mechanical ventilation in acute traumatic cervical spinal cord injured patients

et al. 2017

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Section: Discussionsupporting

confidence: 85%

Section: Discussioncontrasting

confidence: 71%

Section: Discussionsupporting

confidence: 54%

“…In our study, 41.1% of patients with an acute cervical spinal cord injury required MV. Other authors have published higher percentages: Claxton et al 57%, Jones et al 57.6% [14,15].…”

Section: Discussionmentioning

confidence: 89%

Section: Discussionmentioning

confidence: 99%

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Risks factors of mechanical ventilation in acute traumatic cervical spinal cord injured patients

et al. 2017

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Spinal Cord Injury

Stahel

Chatain

Finn

2022

Textbook of Polytrauma Management

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Prolongiertes Weaning in der neurologisch-neurochirurgischen Frührehabilitation

Rollnik

Adolphsen²,

Bauer

et al. 2017

Nervenarzt

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Prolonged weaning of patients with neurological or neurosurgery disorders is associated with specific characteristics, which are taken into account by the German Society for Neurorehabilitation (DGNR) in its own guideline. The current S2k guideline of the German Society for Pneumology and Respiratory Medicine is referred to explicitly with regard to definitions (e.g., weaning and weaning failure), weaning categories, pathophysiology of weaning failure, and general weaning strategies. In early neurological and neurosurgery rehabilitation, patients with central of respiratory regulation disturbances (e.g., cerebral stem lesions), swallowing disturbances (neurogenic dysphagia), neuromuscular problems (e.g., critical illness polyneuropathy, Guillain-Barre syndrome, paraplegia, Myasthenia gravis) and/or cognitive disturbances (e.g., disturbed consciousness and vigilance disorders, severe communication disorders), whose care during the weaning of ventilation requires, in addition to intensive medical competence, neurological or neurosurgical and neurorehabilitation expertise. In Germany, this competence is present in centers of early neurological and neurosurgery rehabilitation, as a hospital treatment. The guideline is based on a systematic search of guideline databases and MEDLINE. Consensus was established by means of a nominal group process and Delphi procedure moderated by the Association of the Scientific Medical Societies in Germany (AWMF). In the present guideline of the DGNR, the special structural and substantive characteristics of early neurological and neurosurgery rehabilitation and existing studies on weaning in early rehabilitation facilities are examined.Addressees of the guideline are neurologists, neurosurgeons, anesthesiologists, palliative physicians, speech therapists, intensive care staff, ergotherapists, physiotherapists, and neuropsychologists. In addition, this guideline is intended to provide information to specialists for physical medicine and rehabilitation (PMR), pneumologists, internists, respiratory therapists, the German Medical Service of Health Insurance Funds (MDK) and the German Association of Health Insurance Funds (MDS). The main goal of this guideline is to convey the current knowledge on the subject of "Prolonged weaning in early neurological and neurosurgery rehabilitation".

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Predictors of the necessity for early tracheostomy in patients with acute cervical spinal cord injury: a 15-year experience

Cited by 30 publications

References 21 publications

Risks factors of mechanical ventilation in acute traumatic cervical spinal cord injured patients

Risks factors of mechanical ventilation in acute traumatic cervical spinal cord injured patients

Spinal Cord Injury

Prolongiertes Weaning in der neurologisch-neurochirurgischen Frührehabilitation

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