Format

Send to

Choose Destination
J Spinal Cord Med. 2007;30(4):309-18.

Respiratory management during the first five days after spinal cord injury.

Author information

1
Santa Clara Valley Medical Center, 751 S. Bascom Avenue, San Jose, CA 95128, USA. michael.berlly@hhs.sccgov.org

Abstract

Respiratory complications are the most common cause of morbidity and mortality in acute spinal cord injury (SCI), with an incidence of 36% to 83%. Eighty percent of deaths in patients hospitalized with cervical SCI are secondary to pulmonary dysfunction, with pneumonia the cause in 50% of the cases. The number of respiratory complications during the acute hospital stay contributes significantly to the length of hospital stay and cost. Four factors (use of mechanical ventilation, pneumonia, the need for surgery, and use of tracheostomy) explain nearly 60% of hospital costs and may be as important a predictor of hospital cost as level of injury. Atelectasis (36.4%), pneumonia (31.4%), and ventilatory failure (22.6%) are the most common complications during the first 5 days after injury. Ventilatory failure occurs on average 4.5 days after injury. Transfer to an SCI center specializing in acute management of tetraplegia has been shown to significantly reduce the number of respiratory complications. This review concentrates on the first 5 days after injury, focusing on complications, predictive factors, prevention, and management of those complications.

PMID:
17853652
PMCID:
PMC2031940
[Indexed for MEDLINE]
Free PMC Article

Supplemental Content

Full text links

Icon for PubMed Central
Loading ...
Support Center