The medical records were reviewed for discharge notes, imaging studies, and pulmonary function tests, including ventilation monitoring results. Individuals refusing any follow-up despite the necessity for further management were also excluded. Individuals who died from unexpected accidents or sepsis due to other causes, except pneumonia, were excluded. The rehabilitation expert team consists of medical specialists of rehabilitation medicine, physical therapists, pulmonary physiotherapists, occupational therapists, assistant nurse practitioners, and social workers. In our institution, pulmonary rehabilitation includes respiratory function assessment, ventilatory support and status monitoring, decannulation or extubation, and daily pulmonary rehabilitation, focusing on non-invasive method. Individuals with HCSCI admitted to our pulmonary center for pulmonary rehabilitation from January 2011 to December 2020 were recruited 133 consecutive cases were included. This retrospective study was conducted at the pulmonary rehabilitation center at a tertiary university hospital, where most individuals with HCSCI and ventilatory insufficiency throughout Korea are referred. This study details our experience managing the respiratory recovery of individuals with HCSCI by retrospectively analyzing courses in respiratory management to provide a reference for other pulmonary clinics. However, proper respiratory care management with effective secretion clearance can prevent ventilatory problems. Prematurely ceasing MV support aggravated by ventilatory insufficiency results in an unnecessary tracheostomy, which is disadvantageous for the individual. Therefore, predicting chronic conditions and providing proper respiratory management based on the SCI status are necessary. Individuals with HCSCI have a higher rate of ventilatory insufficiency than those with lower cervical or thoracic level injuries. Thereafter, age-related decline occurs faster for those requiring assistance than for those who can live independently or with minimal assistance. ![]() In the first year after the injury, the respiratory function increases as other functions recover. Pulmonary rehabilitation after SCI with respiratory complications was developed and studied to improve respiratory function recovery in the acute phase and quality of life in the chronic phase. Individuals with high cervical SCI (HCSCI) have higher morbidity and mortality due to respiratory complications, resulting in an increased risk of tracheostomy or increased dependency on mechanical ventilation (MV). Respiratory dysfunction in spinal cord injury (SCI) can lead to respiratory complications, such as reduced vital capacity (VC), impaired secretion clearance, and autonomic dysfunction. Pulmonary rehabilitation in individuals with HCSCI should be emphasized in the aspect of improving quality of life by avoiding unwanted tracheostomy and changing management methods depending on their recovery. Respiratory management in complete or sensory incomplete HCSCI needs to be determined by reflecting the current ventilatory state with a comprehensive evaluation of pulmonary function and ventilatory state monitoring. Of those with MV via tracheostomy on admission, 25 were switched to non-invasive MV after decannulation. ![]() Of the individuals who had tracheostomy tubes without ventilatory support, 30 underwent decannulation and were discharged without non-invasive MV support. At the final follow-up, 76 individuals (57.1%) still required mechanical ventilation (MV) and 37 (27.8%) still required indwelling tracheostomy tubes. In total, 133 individuals with a C1–4 neurological level of injury (A: 101 or B: 32 on the American Spinal Injury Association Impairment Scale) were identified 110 (82.7%) had indwelling tracheostomy tubes at admission and 75 underwent successful decannulation during admission. The medical records of individuals with complete or sensory incomplete HCSCI admitted to the pulmonary rehabilitation center and receiving the center’s standard treatment were retrospectively reviewed, focusing on respiratory state transitions. SettingĪ tertiary university hospital’s pulmonary rehabilitation center to which most individuals with HCSCI and ventilatory insufficiency throughout Korea are referred. To detail respiratory management after a high cervical spinal cord injury (HCSCI).
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |