Respiratory Management of Pediatric Patients with Spinal Cord Injuries: Retrospective Review of the duPont Experience  

Oleh:

Padman, Raj ; Alexander, Michael ; Thorogood, Christine ; Porth, Susan

Jenis: Article from Journal - ilmiah internasional
Dalam koleksi: Neurorehabilitation and Neural Repair vol. 17 no. 1 (Mar. 2003), page 32–36.
Topik: Respiratory management; Spinal cord injury; Tracheostomy; Ventilator dependent; Weaning
Fulltext: 32NNR171.pdf (157.32KB)

Isi artikel

Pulmonary complications contribute to morbidity and mortality in spinal cord injuries (SCIs). A retrospective review of 20 years of experience with tracheostomy- and ventilator-dependent SCI children is presented. The authors developed and analyzed a database of 47 children (average age = 11.4 years). Of the patients, 27% had concomitant brain injuries, 6% had prior histories of reactive airway disease, and 2% had thoracic fractures. Injuries were caused by motor vehicle accidents (53%); gunshot wounds (19%); sports-related accidents (19%); and vascular injuries, transverse myelitis, or spinal tumors (8%). Of the injuries, 52% were high level (C1 to C2) and 48% were mid- or low level (C3 to C5). Two groups were analyzed for demographic information. Complications included tracheitis, atelectasis, and pneumonia. Mean tidal volume was 14 cm2/kg (maximum = 22 cm2/kg). Bedside lung function parameters were attempted to assess readiness and the rapidity of weans. T-piece sprints were used to successfully wean 63% of patients. Successfully weaned patients were compared with those not weaned. No deaths or readmissions for late-onset respiratory failure postwean occurred. The authors’ clinical impression favors higher tidal volumes and aggressive bronchial hygiene to minimize pulmonary complications and enhance weaning. Successfully weaned patients had fewer complications. A critical pathway for respiratory management of SCI children is presented.

Opini Anda

Klik untuk menuliskan opini Anda tentang koleksi ini!

Kembali