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

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....

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Autores principales: Hendershot, Kristopher A., O’Phelan, Kristine H.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9861966/
https://www.ncbi.nlm.nih.gov/pubmed/36675758
http://dx.doi.org/10.3390/jpm13010097
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author Hendershot, Kristopher A.
O’Phelan, Kristine H.
author_facet Hendershot, Kristopher A.
O’Phelan, Kristine H.
author_sort Hendershot, Kristopher A.
collection PubMed
description 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.
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spelling pubmed-98619662023-01-22 Respiratory Complications and Weaning Considerations for Patients with Spinal Cord Injuries: A Narrative Review Hendershot, Kristopher A. O’Phelan, Kristine H. J Pers Med Review 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. MDPI 2022-12-31 /pmc/articles/PMC9861966/ /pubmed/36675758 http://dx.doi.org/10.3390/jpm13010097 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Review
Hendershot, Kristopher A.
O’Phelan, Kristine H.
Respiratory Complications and Weaning Considerations for Patients with Spinal Cord Injuries: A Narrative Review
title Respiratory Complications and Weaning Considerations for Patients with Spinal Cord Injuries: A Narrative Review
title_full Respiratory Complications and Weaning Considerations for Patients with Spinal Cord Injuries: A Narrative Review
title_fullStr Respiratory Complications and Weaning Considerations for Patients with Spinal Cord Injuries: A Narrative Review
title_full_unstemmed Respiratory Complications and Weaning Considerations for Patients with Spinal Cord Injuries: A Narrative Review
title_short Respiratory Complications and Weaning Considerations for Patients with Spinal Cord Injuries: A Narrative Review
title_sort respiratory complications and weaning considerations for patients with spinal cord injuries: a narrative review
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9861966/
https://www.ncbi.nlm.nih.gov/pubmed/36675758
http://dx.doi.org/10.3390/jpm13010097
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