医学
麻醉
通气不足
机械通风
通风(建筑)
呼吸系统
肺不张
脊髓损伤
插管
脊髓
肺炎
重症监护医学
呼吸衰竭
肺
内科学
工程类
精神科
机械工程
作者
Rita Azucena Díaz Vázquez,P. Rascado Sedes,Mónica Mourelo Fariña,Antonio Marques,Mayda Velasco
摘要
Spinal cord injuries (SCIs) often lead to impairment of the respiratory system and, consequently, restrictive respiratory changes. Paresis or paralysis of the respiratory muscles can lead to respiratory insufficiency, which is dependent on the level and completeness of the injury. Respiratory complications include hypoventilation, a reduction in surfactant production, mucus plugging, atelectasis, and pneumonia. Vital capacity (VC) is an indicator of overall pulmonary function; patients with severely impaired VC may require assisted ventilation. It is best to proceed with intubation under controlled circumstances rather than waiting until the condition becomes an emergency. Mechanical ventilation can adversely affect the structure and function of the diaphragm. Early tracheostomy following short orotracheal intubation is probably beneficial in selected patients. Weaning should start as soon as possible, and the best modality is progressive ventilator-free breathing (PVFB). Appropriate candidates can sometimes be freed from mechanical ventilation by electrical stimulation. Respiratory muscle training regimens may improve patients’ inspiratory function following a SCI.
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