Relationship between Airway Management and Duration of Mechanical Ventilation in Cervical Spine Trauma
Sidi Mohammed Medjadi1* and L Cherfi2
1Department of Anesthesia and Intensive Care, Aboubekr Belkaïd University, Tlemcen, Algeria
2Department of Anesthesia and Intensive Care, Hospital Center Henri Mondor, Aurillac, France
*Corresponding Author: Sidi Mohammed Medjadi, Department of Anesthesia and Intensive Care, Aboubekr Belkaïd University, Tlemcen, Algeria.
January 24, 2022; Published: April 18, 2022
Objectives: The aim of this work is to study the relationship between the early airway management and duration of mechanical ventilation, in the context of improving the prognosis of cervical spine trauma patients.
Patients and Methods: Exhaustive descriptive-type study with prospective collection, carried out over a period of three and a half years at the level of several structures of Tlemcen University Hospital, namely the medical and surgical emergencies, multipurpose resuscitation and neurosurgery departments. It focuses on cervical spine trauma patients treated from the accident scene to the neurosurgery and/or medico-surgical resuscitation departments of Tlemcen University Hospital. All admitted for cervical spine trauma, whatever the level reached; the mechanism of the accident; the therapeutic decision (surgical or orthopedic), with or without neurological lesions and over 16 years old.
Results: Orotracheal intubation was performed in 32.81% of the 128 patients identified in our study, it should be noted that two patients arrived already intubated. 25% were intubated in the first day and 3.1% in the second day. The last patient to be intubated, was on the 16th day following his hospitalization. The ventilatory parameters were regulated in such a way as to have a SPo2 > 90%. The sedation of our patients in the intensive care units was ensured by the combination of Midazolam and Fentanyl with an electric syringe, and maintained until clinical and radiological improvement. All were sedated and placed on mechanical ventilation. Of all intubated patients, 7.81% received a tracheostomy while in hospital. The median survival is 3 ± 5.47 days in the group of patients who have been intubated and 74 ± 1.42 days in the group who have not been.
Conclusion: It is concluded that the occurrence of infectious broncho pulmonary complications in 31% of intubated patients (13/42 intubated) was correlated with the duration of hospitalization of our cervical spine trauma patients at Tlemcen University Hospital, establishing thus skip a statistically significant relationship between them (P = 0.000).
Keywords: Cervical Spine Trauma; Airway Management; Mechanical Ventilation; Infectious Respiratory; Length of Hospitalization
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