title: An intermediate respiratory care unit for spinal cord-injured patients. A retrospective study.
abstract: OBJECTIVE
  Patients with cervical spinal cord injury (SCI) may need prolonged mechanical ventilation (MV) and a long stay in the Intensive Care Unit. An intermediate respiratory care unit (IRCU) can shorten that stay, optimizing hospital resources. The aim of our work has been to evaluate the activity of such a unit in our hospital.
  
  
  METHODS
  This is a descriptive retrospective study based on the data of patients with SCI and respiratory failure discharged from our IRCU between 1 July 2010 and 28 February 2013.
  
  
  RESULTS
  We have analysed data from 146 patients with SCI, adding up to 228 admissions (68 first admissions and 160 readmissions due to complications or scheduled review visits). Sixty-three out of the 68 newly admitted patients survived their first admission (92.6%). Length of hospitalization was 195.6±110.4 days, 22 were admitted to monitor their respiratory status and 46 were on MV on admission. Of these, 26 (38.2%) were admitted to attempt weaning from the respirator and 20 (29.4%) to enter a programme of permanent respiratory support. Weaning was successful in 23 out of 26 patients (88.4%), the process taking 47.2±49.3 days. Forty of them (58.8%) were discharged to their home.
  
  
  CONCLUSIONS
  An IRCU can manage a substantial number of severe SCI patients who need MV, and an important number of them can be weaned from the respirator. It may also achieve a good success rate in the integration of MV-dependent patients within family and society.
authors.affiliation: Intermediate Respiratory Care Unit, Internal Medicine Service, Toledo, Spain.
authors.forename: J
authors.initials: J
authors.lastname: Romero-Ganuza
authors.affiliation: Intermediate Respiratory Care Unit, Internal Medicine Service, Toledo, Spain.
authors.forename: A
authors.initials: A
authors.lastname: García-Forcada
authors.affiliation: Rehabilitation Medicine Service, National Hospital of Paraplegics, Toledo, Spain.
authors.forename: E
authors.initials: E
authors.lastname: Vargas
authors.affiliation: Intermediate Respiratory Care Unit, Internal Medicine Service, Toledo, Spain.
authors.forename: C
authors.initials: C
authors.lastname: Gambarrutta
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care / Q000706:statistics & numerical data*; D012121:Respiration, Artificial / Q000706:statistics & numerical data*; D012124:Respiratory Care Units / Q000706:statistics & numerical data*; D012131:Respiratory Insufficiency / Q000209:etiology / Q000628:therapy*; D012189:Retrospective Studies; D013119:Spinal Cord Injuries / Q000150:complications*; D016896:Treatment Outcome