Spinal injuries

Arora, Sumesh; Flower, Oliver

doi:10.1016/b978-0-7020-4762-6.00078-3

Cited by 1 publication

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“…This therapy is still controversial; The latest study states that there are no class 1 and 2 studies on the basis of this therapy, and found side effects in the form of gastric bleeding, infection, sepsis, increased length of stay in the ICU, and death. 2,3,13,15 This patient received corticosteroid therapy in the form of methylprednisolone 125 mg IV/8 hours to prevent inflammation until second days after surgery. A meta-analysis study conducted by Liu Z, et al in 2019, there were no differences in motor and sensory function outcomes in SCI patients who received high doses of methylprednisolone and those who did not.…”

Section: Graph 1 Results Of Temporary Blood Sugar (Tbs) Examinationmentioning

confidence: 99%

Management of Patients Post Laminectomy Decompression Et Causa Spinal Cord Injury Cervical Vertebrae 1-7 with Hyperglikemia in Intensive Care Unit

Yusuprihastuti,

Adiyanto,

Arifin

2024

JAI b

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Background: In the United States, in 2008 of 100,000 cases of spinal cord injury, 2/3 were cases of cervical injury. Patients who experience cervical to thoracic Spinal Cord Injury (SCI) above T8, usually have impaired function of the diaphragm and intercostal muscles which causes respiratory failure. Neurogenic shock occurs in patients who experience SCI above T6 which causes vasodilation, hypotension and severe bradycardia or asystole when stimulating vagal reflexes such as laryngoscopy or suctioning.Case: The patient was diagnosed with SCI cervical vertebrae 1-7. The patient underwent decompressive laminectomy et causa SCI cervical vertebrae 1-7 and hyperglycemia. Management includes surgical therapy, management of respiratory failure in the Intensive Care Unit (ICU), pharmacological therapy include insulin for hyperglicemia control, and support for neurogenic shock and physioterapy.Discussion: Patients with SCI require laminectomy, supportive therapy, pharmacotherapy include insulin, neurogenic shock, and respiratory support if there is respiratory failure. In cases of injury to cervical vertebrae 1-7, the patient requires ventilator support to assist the function of the diaphragm and intercostal muscles, pharmacological supportive therapy for neurogenic shock, as well as care from a sub-endocrine specialist to treat hyperglycemia. Stress-induced hyperglycemia was occurred due to CNS injury.Conclusion: Spinal Cord Injury (SCI) is a disorder of the spinal cord or spinal cord with neurological symptoms ranging from motor, sensory and autonomic function. Respiratory failure in SCI above thoracic 8, is due to disturbances in the function of the diaphragm and intercostal muscles. The occurrence of neurogenic shock in SCI cases, especially above thoracic 6, manifests in the form of vasodilation, hypotension and severe bradycardia or asystole. Management in the ICU includes hemodynamic monitoring, respiratory failure, prevention of neurogenic shock, and pharmacology to treat hyperglycemia. Biochemical parameters, nutritional status, and respiratory function were also monitored.

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Section: Graph 1 Results Of Temporary Blood Sugar (Tbs) Examinationmentioning

confidence: 99%