title: Respiratory nursing interventions following tracheostomy in acute traumatic cervical spinal cord injury.
abstract: Tracheostomy is frequently performed in severe cervical spinal cord injury (SCI) patients with the pulmonary dysfunction. A series of respiratory nursing interventions are required to plan tracheostomy removal. Tracheostomy was performed in 29 patients after acute traumatic cervical SCI. A series of respiratory nursing interventions were introduced in these patients after closed tracheostomy and decannulation, including closed tracheostomy tube training, manually assisted cough. Chacheostomy was successfully removed in 21 patients after the respiratory nursing interventions. In contrast, eight patients died from associated injuries. The average time from tracheostomy to decannulation was 40 days (14-104 days), the average time from closed tracheostomy to decannulation was 18.80 ± 13.50 days. Second tracheostomy was performed in one patient after 29 days' removal due to pulmonary infection. One patient presented with delayed incision healing for 29 days. Closed tracheostomy tube training and manually assisted cough are key factors for tracheostomy removal, although intensive nursing are also needed. The time from tracheostomy to decannulation and from closed tracheostomy to decannulation is increased in case of "late" (>24 h) tracheostomy and longer mechanical ventilation.
authors.affiliation: Department of Orthopedics, Xinqiao Hospital, Third Military Medical University, 183 Xinqiao Street, Shapingba District, Chongqing, 400037, China.
authors.forename: Chunmei
authors.initials: C
authors.lastname: Luo
authors.forename: Hongli
authors.initials: H
authors.lastname: Yang
authors.forename: Yu
authors.initials: Y
authors.lastname: Chen
authors.forename: Zhengfeng
authors.initials: Z
authors.lastname: Zhang
authors.forename: Zili
authors.initials: Z
authors.lastname: Gong
mesh_terms: D000208:Acute Disease / Q000451:nursing; D000293:Adolescent; D000328:Adult; D000368:Aged; D066193:Cervical Cord / Q000293:injuries*; D002648:Child; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012137:Respiratory System; D012189:Retrospective Studies; D013119:Spinal Cord Injuries / Q000451:nursing* / Q000601:surgery*; D014139:Tracheostomy; D055815:Young Adult