Impact of Early Tracheostomy on Hospital-Acquired Pneumonia and Infection of Anterior Cervical Fusion Site in Patients with Acute Cervical Cord Injury

Background: Pneumonia is the most common hospital acquired infection in the intensive care unit. One of the causes for hospital acquired pneumonia is ventilator associated pneumonia. Tracheostomy is known to prevent occurrence of ventilator associated pneumonia as it decreases the respiratory dead space, assists in better clearance of secretions and prevents chances of aspiration. Generally, tracheostomy is done after 2 weeks of endotracheal intubation to prevent tracheal complications. The aim of this study is to identify the incidence of ventilator associated pneumonia in tracheostomised and non tracheostomised patients and to see if early tracheostomy can prevent development of ventilator associated pneumonia.Methods: The study was conducted at a tertiary care hospital during a period of four years. 100 patients who were on mechanical ventilation for more than 7 days where taken up for the study. APACHE 4 scoring system was used. The incidence of Ventilator associated pneumonia in tracheostomised and non tracheostomised patients was studied.Results: In our study the total incidence of VAP was 44 %. In our study out of the 42 patients who had undergone tracheostomy 13 (30.95%) patients had ventilator associated pneumonia. Among the non-tracheostomised patients 31 (53.44%) out of 58 patients developed ventilator associated pneumonia. In our study the incidence of ventilator associated pneumonia was much lesser (12%) in patients who underwent tracheostomy in the period 7 to 10 days after mechanical ventilation, whereas in those who underwent tracheostomy after 11 days incidence of ventilator associated pneumonia was much higher.Conclusions: Our study showed that the incidence of ventilator associated pneumonia was much higher among non tracheostomised patients compared to patients who underwent tracheostomy. Hence patients undergoing earlier tracheostomy had a clear advantage than those undergoing tracheostomy late or non tracheostomised patients in preventing ventilator associated pneumonia.

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Series of Trials to Apply Communication Aids to a Patient with High Cervical Cord Injury.

The Japan Journal of Logopedics and Phoniatrics ◽

10.5112/jjlp.37.435 ◽

1996 ◽

Vol 37 (4) ◽

pp. 435-442

Author(s):

Mami Mitachi (Hori)

Keyword(s):

Cervical Cord ◽

Communication Aids ◽

Cord Injury ◽

High Cervical ◽

Cervical Cord Injury

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The condition of cerebral hemodynamic at patients with cervical injury of spine

Bulletin of Siberian Medicine ◽

10.20538/1682-0363-2011-4-146-151 ◽

2011 ◽

Vol 10 (4) ◽

pp. 146-151

Author(s):

T. G. Vstavskaya ◽

V. I. Larkin ◽

L. B. Reznik ◽

N. I. Nazarova

Keyword(s):

Doppler Sonography ◽

Transcranial Doppler Sonography ◽

Cervical Cord ◽

Control Group ◽

Cervical Injury ◽

Cervical Trauma ◽

Brain Vessels ◽

Cerebral Hemodynamic ◽

Cord Injury ◽

Cervical Cord Injury

The condition of cerebral hemodynamic at the patients who transferred a cervical trauma of a backbone during the early and intermediate periods was studied. Examined 48 patients at the age of 18—50 years with cervical injury of spine during the early and intermediate periods. Patients were grouped according anatomical particularizes of cervical cord injury and influenced at spinal cord. Besides neurologic inspection, methods of ultrasonic Doppler sonography extracranial and transcranial Doppler sonography of intracranial brain vessels. The most essential changes of a blood-groove were registered in vertebrobasilar pool in a group with a complicated inferior cervical backbone trauma (deficiency of a blood-groove on 30—32% from control group р < 0,05). At patients with not complicated inferior cervical trauma authentically changed only intracranial blood-groove on vertebralis arteries (decrease on 19—26% on the average; р < 0,05). Characteristic changes for patients with a cranivertebral trauma of hemodynamic have not been revealed. The cerebral hemodynamic during the early and intermediate periods was changed at the patients on severity lower level of a cervical trauma of a backbone.

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