Respiratory complications in pediatric patients with acute traumatic spinal cord injury in Spain

Abstract

Spinal cord injury (SCI) in the pediatric age continues to be an unusual pathology. In Spain, the incidence of SCI in children is low, being approximately 1 per million inhabitants per year, corresponding to the 4%. However, there is not enough statistical data to determine how many of these correspond to traumatic injuries. In the acute phase, especially in cervical and upper thoracic SCI, respiratory complications remain the leading cause of death. Retrospective study of all patients aged 0–18 years, who suffered traumatic acute spinal cord injury above D6, admitted to the University Hospital Vall D’Hebron, Barcelona from March 2010 to August 2017 using a database specific of the unit. The objective of the study was to determine the incidence of respiratory complications in these patients with respect to the adult population of our center and to correlate the appearance of these complications with the early onset of respiratory physiotherapy. The total number of children with spinal cord injury was 46, of which 27 were excluded due to spinal cord injury below D6 or traumatic brain injury, thus obtaining a study sample of 19 patients. The 52.6% presented respiratory complications; this result is higher when compared with the adult population of our center (incidence of 36.5%). When correlating the early onset of respiratory physiotherapy and the development of these complications, we found that none of the patients who started the treatment within 72 hours after the injury presented respiratory complications. In our center, there is a higher incidence of respiratory complications in pediatric patients affected by acute traumatic SCI when compared to adults. There is a significant relationship regarding the impact and importance of the initiation of early physiotherapy, between 72 hours after the SCI, in the prevention of the development of respiratory complications.