Successful weaning from mechanical ventilation in the quadriplegia patient with C2 spinal cord injury undergoing C2-4 spine laminoplasty: A case report.
10.4097/kjae.2013.64.6.545
- Author:
Jee Eun CHANG
1
;
Sang Hyun PARK
;
Sang Hwan DO
;
In Ae SONG
Author Information
1. Department of Anesthesiology and Pain Medicine, Seoul National University Hospital, Seoul, Korea.
- Publication Type:Case Report
- Keywords:
Cervical spinal injury;
Quadriplegia;
Ventilator weaning
- MeSH:
Cough;
Diaphragm;
Humans;
Paralysis;
Quadriplegia;
Respiration, Artificial;
Respiratory Insufficiency;
Spinal Cord;
Spinal Cord Injuries;
Spine;
Ventilator Weaning;
Weaning
- From:Korean Journal of Anesthesiology
2013;64(6):545-549
- CountryRepublic of Korea
- Language:English
-
Abstract:
In patients with cervical spine injuries, respiratory function requires careful attention. Voluntary respiratory control is usually possible with lesions below C4 level although paralysis of the abdominal musculature results in a decreased ability to cough and to clear secretions, which may later lead to respiratory insufficiency. Therefore, injuries above C5 usually necessitate long term mechanical ventilation. Even though weaning criteria are not definitive for the quadriplegic patient, M-mode ultrasonography of the diaphragm may be useful in identifying patients at high risk of difficulty weaning. Diaphragmatic dysfunction (vertical excursion < 10 mm or paradoxical movements) results in frequent early and delayed weaning failures. We present our clinical experience with successful weaning by using M-mode ultrasonography and a cough-assist device for secretion clearance after extubation in a quadriplegic patient undergoing C2-4 spine laminoplasty.
