[Pediatric acute spinal cord injury].
BACKGROUND
Pediatric acute spinal cord injury is rare but is often associated with significant disability and prolonged stay in the intensive care unit (ICU).


OBJECTIVE
The main objective of this study was to determine the epidemiology, initial clinical abnormalities, diagnostic studies, treatment and outcome of acute spinal cord injuries in a tertiary level pediatric hospital. A second objective was to analyze whether early tracheostomy allows earlier discharge of these patients.


METHODS
A retrospective analysis of patients with acute spinal cord injuries admitted to our pediatric ICU since 1992 was performed.


RESULTS
We included 16 patients in the study, 12 of whom were boys (75 %). The patients were aged from birth to 19 years on admission to the ICU. The length of stay in the ICU was between 12 hours and 6 years. The cause of the lesion was birth trauma in four patients; one died and the remaining three live at home under mechanical ventilation. Traumatic injuries occurred in seven patients, two of whom died; a further two live in a long-term care facility and the remaining three live at home. Vascular spinal malformation occurred in two patients, and the three remaining injuries occurred during the acute postoperative period following spinal surgery. Of the 16 children, 56.2 % were tracheostomized and 83 % of the survivors live at home.


CONCLUSIONS
Early tracheostomy, the availability of invasive ventilation for home use and parent education permit earlier discharge of these patients and allow more of them to live at home.
Claret Teruel
G
G
Unidad de Cuidados Intensivos, Unidad Integrada Hospital Sant Joan de Déu-Clínic, Universidad de Barcelona, Barcelona, España. gclaret@hsjdbcn.org
Trenchs Sáinz de la Maza
V
V
Palomeque Rico
A
A
D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D012189:Retrospective Studies; D013119:Spinal Cord Injuries / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy