Respiratory Complications and Weaning Considerations for Patients with Spinal Cord Injuries: A Narrative Review

被引:5
|
作者
Hendershot, Kristopher A. [1 ]
O'Phelan, Kristine H. [2 ]
机构
[1] Univ Miami, Jackson Mem Hosp, Dept Emergency Med, Miami, FL 33136 USA
[2] Univ Miami, Miller Sch Med, Dept Neurol, Div Neurocrit Care, Miami, FL 33136 USA
来源
JOURNAL OF PERSONALIZED MEDICINE | 2023年 / 13卷 / 01期
关键词
spinal cord injury; respiratory complications; early tracheostomy; predictors of respiratory complications; weaning strategies; AIR STACKING; TRACHEOSTOMY; NEED; INDIVIDUALS; PREDICTORS; EXTUBATION; MANAGEMENT; MOTOR;
D O I
10.3390/jpm13010097
中图分类号
R19 [保健组织与事业(卫生事业管理)];
学科分类号
摘要
Respiratory complications following traumatic spinal cord injury are common and are associated with high morbidity and mortality. The inability to cough and clear secretions coupled with weakened respiratory and abdominal muscles commonly leads to respiratory failure, pulmonary edema, and pneumonia. Higher level and severity of the spinal cord injury, history of underlying lung pathology, history of smoking, and poor baseline health status are potential predictors for patients that will experience respiratory complications. For patients who may require prolonged intubation, early tracheostomy has been shown to lead to improved outcomes. Prediction models to aid clinicians with the decision and timing of tracheostomy have been shown to be successful but require larger validation studies in the future. Mechanical ventilation weaning strategies also require further investigation but should focus on a combination of optimizing ventilator setting, pulmonary toilet techniques, psychosocial well-being, and an aggressive bowel regimen.
引用
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页数:11
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