Korean J Anesthesiol.  2013 Jun;64(6):545-549. 10.4097/kjae.2013.64.6.545.

Successful weaning from mechanical ventilation in the quadriplegia patient with C2 spinal cord injury undergoing C2-4 spine laminoplasty: A case report

• Chang JE
• Park SH
• Do SH
• Song IA

• KMID: 1767441
• DOI: http://doi.org/10.4097/kjae.2013.64.6.545

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.

Keyword

Cervical spinal injury; Quadriplegia; Ventilator weaning

MeSH Terms

Cough
Diaphragm
Humans
Paralysis
Quadriplegia
Respiration, Artificial
Respiratory Insufficiency
Spinal Cord
Spinal Cord Injuries
Spine
Ventilator Weaning
Weaning