Approximately two thirds of people with acute spinal cord injury (SCI) will experience respiratory complications necessitating mechanical ventilation (MV) which is associated with higher morbidity and mortality. Current SCI clinical guidelines recommends tidal volume (TV) setting of ≥ 15 cc/kg ideal body weight for who require MV after acute SCI which is in contrast to the ARDSnet protocol which was developed for patients with acute respiratory distress syndrome (ARDS). Emerging evidence suggests favorable outcomes with low TV ventilation in patients with non ARDS lungs as well. We conducted a retrospective study to determine if higher TV MV in acute SCI is associated with poor outcomes.
Design: Retrospective cohort study
Participants: 43 ventilator dependent people with SCI admitted to acute inpatient rehabilitation (AIR) unit between Jan 2016- Dec 2017 were included.
Intervention: MV with TV of ≤15 cc/kg IBW or >15 cc/kg IBW.
Outcomes: Ventilator weaning days, AIR hospital length of stay (LOS) and incidence of pneumonia.
Hannah Uhlig - Reche– Medical Student, University of Texas Medical School-Houston
Radha Korupolu– Assistant Professor, University of Texas Medical School-Houston
Ellia Ciammaichella– Fellow, University of UTAH
Patrick Mollett– Physician, Us Physiatry
Emmanuel Achilike– Resident, Baylor College of Medicine