Update on traumatic acute spinal cord injury. Part 2.
The aim of treatment in acute traumatic spinal cord injury is to preserve residual neurologic function, avoid secondary injury, and restore spinal alignment and stability. In this second part of the review, we describe the management of spinal cord injury focusing on issues related to short-term respiratory management, where the preservation of diaphragmatic function is a priority, with prediction of the duration of mechanical ventilation and the need for tracheostomy. Surgical assessment of spinal injuries based on updated criteria is discussed, taking into account that although the type of intervention depends on the surgical team, nowadays treatment should afford early spinal decompression and stabilization. Within a comprehensive strategy in spinal cord injury, it is essential to identify and properly treat patient anxiety and pain associated to spinal cord injury, as well as to prevent and ensure the early diagnosis of complications secondary to spinal cord injury (thromboembolic disease, gastrointestinal and urinary disorders, pressure ulcers).
Unidad de Cuidados Intensivos, Complexo Hospitalario Universitario de A Coruña, A Coruña, España.
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Mourelo Fariña
Unidad de Lesionados Medulares, Complexo Hospitalario Universitario de A Coruña, A Coruña, España.
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Salvador de la Barrera
Unidad de Lesionados Medulares, Complexo Hospitalario Universitario de A Coruña, A Coruña, España; Departamento de Medicina, Universidad de A Coruña, A Coruña, España.
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Montoto Marqués
Unidad de Lesionados Medulares, Complexo Hospitalario Universitario de A Coruña, A Coruña, España.
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Ferreiro Velasco
Unidad de Cuidados Intensivos, Complexo Hospitalario Universitario de A Coruña, A Coruña, España. Electronic address: ritagaleiras@hotmail.es.
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Galeiras Vázquez
D000208:Acute Disease; D001007:Anxiety / Q000209:etiology / Q000517:prevention & control; D019299:Decompression, Surgical; D003964:Diaphragm / Q000503:physiopathology; D005767:Gastrointestinal Diseases / Q000209:etiology / Q000628:therapy; D006801:Humans; D018529:Nutritional Support; D059408:Pain Management; D003668:Pressure Ulcer / Q000209:etiology / Q000517:prevention & control; D012120:Respiration Disorders / Q000209:etiology / Q000628:therapy; D012121:Respiration, Artificial; D015656:Respiratory Mechanics; D013117:Spinal Cord Compression / Q000209:etiology / Q000517:prevention & control / Q000628:therapy; D013119:Spinal Cord Injuries / Q000150:complications / Q000534:rehabilitation / Q000628:therapy; D016103:Spinal Fractures / Q000150:complications; D019851:Thrombophilia / Q000209:etiology / Q000628:therapy; D014139:Tracheostomy; D014555:Urination Disorders / Q000209:etiology / Q000628:therapy
Lesión medular/cirugía; Lesión medular/dolor; Prolonged mechanical ventilation; Spinal cord injuries/surgery; Spinal cord injury/pain; Tracheostomy; Traqueostomía; Ventilación mecánica prolongada