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

Montoto-Marqués, Antonio; Trillo-Dono, Natalia; Ferreiro-Velasco, María Elena; Barrera, S. Salvador de la; Rodríguez-Sotillo, Antonio; Fariña, Mónica Mourelo; Galeiras, Rita; Meijide-Faílde, Rosa

doi:10.1038/s41393-017-0005-7

Cited by 16 publications

(3 citation statements)

References 22 publications

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“…The sample sizes of these studies ranged from 146 to 788 patients. 13–16 19 20 Limited sample sizes make it difficult to identify the risk factors for artificial airway demand for patients with acute trauma. Furthermore, the time of the establishment of the artificial airway was not clearly defined.…”

Section: Discussionmentioning

confidence: 99%

“…Several studies [13][14][15][16][17][18][19][20] have explored the predictive system of artificial airways or surgical airways for injured patients, and the risk factors found in those studies included age, 13 gender, 13 18 American Spinal Injury Association (ASIA), 13 16 ASIA Motor Score, 13 16 ISS, 13 state of consciousness, 17 haemodynamic instability, 14 history of smoking, 15 history of lung diseases, 15 trauma mechanism, 17 trauma site, [15][16][17][18] pulmonary complications 14 and so on. The sample sizes of these studies ranged from 146 Open access to 788 patients.…”

Section: Discussionmentioning

confidence: 99%

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Development and validation of a model to predict the need for artificial airways for acute trauma patients in the emergency department: a retrospective case–control study

Li,

Zhang,

et al. 2024

BMJ Open

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ObjectiveTo develop scores for predicting the need for artificial airway procedures for acute trauma patients in the emergency department (ED).DesignRetrospective case–control.SettingA tertiary comprehensive hospital in China.Participants8288 trauma patients admitted to the ED within 24 hours of injury and who were admitted from 1 August 2012 to 31 July 2020.Primary and secondary outcome measuresThe study outcome was the establishment of an artificial airway within 24 hours of admission to the ED. Based on the different feature compositions, two scores were developed in the development cohort by multivariable logistic regression. The predictive performance was assessed in the validation cohort.ResultsThe O-SPACER (Oxygen saturation, Systolic blood pressure, Pulse rate, Age, Coma Scale, Eye response, Respiratory rate) score was developed based on the patient’s basic information with an area under the curve (AUC) of 0.85 (95% CI 0.80 to 0.89) in the validation group. Based on the basic information and trauma scores, the IO-SPACER (Injury Severity Score, Oxygen saturation, Systolic blood pressure, Pulse rate, Age, Coma Scale, Eye response, Respiratory rate) score was developed, with an AUC of 0.88 (95% CI 0.84 to 0.92). According to the O-SPACER and IO-SPACER scores, the patients were stratified into low, medium and high-risk groups. According to these two scores, the high-risk patients were associated with an increased demand for artificial airways, with an OR of 40.16–40.67 compared with the low-risk patients.ConclusionsThe O-SPACER score provides risk stratification for injured patients requiring urgent airway intervention in the ED and may be useful in guiding initial management. The IO-SPACER score may assist in further determining whether the patient needs planned intubation or tracheotomy early after trauma.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Development and validation of a model to predict the need for artificial airways for acute trauma patients in the emergency department: a retrospective case–control study

Li,

Zhang,

et al. 2024

BMJ Open

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“…menunjukkan bahwa sebesar 79% kasus cedera medula spinalis komplit yang melibatkan segmen C5 dan di atasnya memerlukan trakeostomi. 11 Laporan kasus oleh Andrew et al menyajikan pasien yang mengeluhkan sesak napas 3 minggu setelah operasi medula spinalis servikal akibat cedera saraf frenikus hingga menyebabkan paralisis diafragma unilateral. Pasien tersebut menerima suplementasi oksigen sebanyak 3 lpm dan ventilasi tekanan positif dengan BiPAP sebagai dukungan ventilasi.…”

Section: Menurutunclassified

Tatalaksana ICU pada Pasien Pasca Laminektomi Servikal dengan Kesulitan Weaning dan Ekstubasi

Rakhmatjati,

R. W,

Arifin

2023

JAI b

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Latar Belakang: Salah satu penyebab kesulitan weaning adalah gangguan neuromuskuler seperti polineuropati, miopati, dan spinal cord injury (SCI) segmen servikal di atas C5. Angka kegagalan ekstubasi berkisar pada 10-20% dari keseluruhan kasus intensive care unit (ICU) dengan angka kematian 25-50%. Ventilasi mekanik jangka panjang seringkali diperlukan pada pasien dengan cedera medula spinalis segmen di atas C5.Kasus: Kami laporkan 2 pasien; seorang laki-laki 22 tahun dengan diagnosis tetraparese spastik dengan lesi transversal total medula spinalis C5 et causa spinal cord injury, dan pada pasien kedua seorang laki-laki 34 tahun dengan diagnosis tetraplegia akut et causa canal stenosis servikal setinggi C1-3 et causa massa ekstradura et causa squamous cell carcinoma. Kedua pasien juga didiagnosis mengalami kejadian ventilator associated pneumonia (VAP), pasca prosedur pembedahan laminektomi. Penatalaksanaan berupa terapi antibiotik empiris dan de-eskalasi. Pembahasan: Sebagian besar gangguan neuromuskular yang mempersulit weaning diperoleh selama perawatan pasien di ICU. Fungsi sistem pernapasan pada pasien dengan cedera medula spinalis servikal memerlukan perhatian khusus, khususnya segmen level tinggi oleh karena keterlibatan saraf frenikus. Trakeostomi direkomendasikan dilakukan lebih awal setelah intubasi untuk menyederhanakan weaning. Komplikasi pascaoperasi harus diatasi agar tidak memperburuk luaran pasien. Kesimpulan: Kriteria weaning dan ekstubasi pada gangguan neuromuskuler dapat berbeda antar referensi, namun secara umum melibatkan vital capacity (VC), respiratory rate (RR), minute ventilation, PaO2, FiO2, PaCO2, rapid shallow breathing index, positive end-expiratory pressure (PEEP), dan kondisi klinis pasien. Selama weaning, bantuan ventilasi dilepas untuk sementara dan diselingi dengan periode istirahat.

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Surgical outcome and risk factors for cervical spinal cord injury patients in chronic stage: a 2-year follow-up study

Rong

Jia

et al. 2021

Eur Spine J

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

Abstract: Isolated factors associated with a greater risk of MV in tCSCI were: age, gender, ASIA grade, ISS and AMS. However, the only factor with a significant discriminatory ability to determine the need for MV was the AMS at admission.

Cited by 16 publications

References 22 publications

Development and validation of a model to predict the need for artificial airways for acute trauma patients in the emergency department: a retrospective case–control study

Development and validation of a model to predict the need for artificial airways for acute trauma patients in the emergency department: a retrospective case–control study

Tatalaksana ICU pada Pasien Pasca Laminektomi Servikal dengan Kesulitan Weaning dan Ekstubasi

Surgical outcome and risk factors for cervical spinal cord injury patients in chronic stage: a 2-year follow-up study

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