Abstract
Pneumonia is a life-threatening complication for cervical spine injured patients. We studied a retrospective cohort of 80 consecutive patients admitted between 1998 and 2002 in the Emergency Department. Mean age was 43 ± 16 years, sex ratio (female/male) 0.13. Mean SAPS II score was 22 ± 10. Patients with pneumonia were older (49 ± 16 years vs 41 ± 16 years, P < 0.05) and had a higher SAPS II score (26 ± 10 vs 18 ± 9, P < 0.01). The delay of admission in the critical care unit (CCU) was higher in the pneumonia group (0.3 ± 0.7 days vs 3.2 ± 4.0 days, P < 0.01). The delay of handling by a physiotherapist was also higher (3.7 ± 2.0 days vs 8.1 ± 8.0 days, P < 0.01). Pneumonia was associated with a longer period of mechanical ventilation (10 ± 11 days vs 21 ± 13 days, P < 0.05) and a longer stay in the CCU (8.6 ± 9.5 vs 39.2 ± 29.3, P < 0.0001). Univariate analysis of qualitative factors is presented in Table Table1.1. Early mechanical ventilation, upper cervical spine involvment and inhospital mortality were not related to pneumonia. Overall mortality is higher in the pneumonia group. Table 1 Our study suggests that an early and aggressive handling of patients with cervical spine injury, particularly with complete motor deficit, could be beneficial to decrease pneumonia incidence and its associated adverse events.
Highlights
In contrast to conventional surgical tracheostomy, percutaneous dilational tracheostomy (PDT) in different variants is spreading rapidly in intensive care units today
Summary Our study demonstrated that LS is a good alternative to restore cardiac contractile function when combined with NE
The use of AVP may lead to further deteriorate sepsis-related myocardial dysfunction even when combined with a positive inotropic agent
Summary
In contrast to conventional surgical tracheostomy, percutaneous dilational tracheostomy (PDT) in different variants is spreading rapidly in intensive care units today. The objectives of the current study were (1) to assess the prognostic significance of plasma concentrations of NSE for early prediction of outcome in patients at risk for anoxic encephalopathy after cardiopulmonary resuscitation (CPR), and (2) to compare the prognostic information provided by NSE measurements with that provided by conventional risk indicators (clinical neurological examination and computerised tomography [CT] scan of the brain). Independent pulmonary ventilation was introduced in the 1930s and allows the utilization of different ventilatory strategies for each lung to improve gas exchange, respiratory mechanics or both in patients with heterogeneous lung diseases It is not clear whether the lower inflection point (LIP) on the inspiratory limb or the point of maximum curvature (PMC) on the deflation limb of the pressure–volume (PV) curve should be used for the positive end-expiratory pressure (PEEP) setting in acute lung injury (ALI). The long-term outcome, health-related quality of life (HRQL), and ICU and hospital costs of medical ICU patients were assessed
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