Journal Browser Advanced Search Help
Journal Browser Advanced search HELP
Korean J Anesthesiol. 2013 Jun;64(6):545-549. English. Case Report.
Chang JE , Park SH , Do SH , Song IA .
Department of Anesthesiology and Pain Medicine, Seoul National University Hospital, Seoul, Korea.
Department of Anesthesiology and Pain Medicine, Seoul National University Bundang Hospital, Seongnam, Korea. psh1399@snnubh.org
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.

Copyright © 2019. Korean Association of Medical Journal Editors.