This presentation deals with an 11 year survey of 106 cervical spinal cord injuries, admitted immediately after injury or during the very acute phase, to the Traumatology Resuscitation Unit of Colmar, (France). A preliminary report concerning 51 patients was published in 1979. The follow-up study concerns a further 55 cervical spinal cord injured patients admitted from January 1979 to December 1984. The emphasis of our presentation concerns the frequency of some of the main complications and their attempted prevention: the haemodynamic disturbances caused by over-hydration; the prevention of haemorrhagic stress ulcers is not only by the use of specific drugs, but mainly by immediate intravenous adequate caloric nutrition. This can be associated with, or followed as soon as possible by, an adapted caloric diet, possibly by a naso-gastric tube. For serious respiratory complications, artificial ventilation even for long periods as discussed, by nasal intubation or in some patients tracheotomy.
Barois A, Gschaedler R, Dollfus P 1981 Le traitement médical d'urgence. La Paraplégie (Maury M.) (pp. 49–63) Flammarion Medecine-Sciences, Paris
Claus-Walker J, Carter R E, Di Ferrante N M, Singh J 1977 Immediate endocrine and metabölic consequences of traumatic quadriplegia in a young woman. Paraplegia 15: 202–208
Faden A T, Jacobs T P, Smith M T, Holaday J W 1983 Comparison of thyrotropin-releasing hormone (TRH), naloxone, and dexamethasone treatments in experimental spinal injury. Neurology 33: 673–678
Faden A I, Jacobs T J, Patrick D F, Smith M T 1984 Megadose corticosteroid therapy following experimental traumatic spinal injury. Journal of Neurosurgery 60: 712–717
Frankel H L 1970 Tracheal stenosis following tracheostomy. Paraplegia 8: 172–176
Gschaedler R, Dollfus P, Mole J P, Mole L, Loeb J P 1979 Reflections on the intensive care of acute cervical spinal cord injuries in a general traumatology centre. Paraplegia 17: 58–61
Hachen H J 1977 Idealised care of the acutely injured spinal cord in Switzerland. The Journal of Trauma 17: 931–936
Hachen H J, Barois A, Gschaedler R 1981 Les complications cardiovasculaires. La Paraplégie (Maury M.) (pp. 130–132). Flammarion Medecine-Sciences, Paris.
Mackenzie C F, Shin B, Krishnaprasad D, McCormack F 1985 Assessment of cardiac and respiratory function during survey on patients with acute quadriplegia. Journal of Neurosurgery 62: 843–849
El Masri W, Cochrane P, Silver J R 1983 Gastrointestinal bleeding in patients with acute spinal injuries. Injury: The British Journal of Accident Surgery 14: 162–167.
Philippi R, Kuhn W, Zach G A, Jacob-Chia D, Dollfus P, Mole J F 1980 Survey of the neurological evolution of 300 spinal cord injuries seen within 24 hours after injury. Paraplegia 18: 337–346
Zach G A, Seiler W 1977 Lésion de la muqueuse gastroduodénale et choc spinal. Annales de Médecine Physique 20: 340–342
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Dietz, J., Bertschy, M., Gschaedler, R. et al. Reflections on the intensive care of 106 acute cervical spinal cord injury patients in the resuscitation unit of a general traumatology centre. Spinal Cord 24, 343–349 (1986). https://doi.org/10.1038/sc.1986.51
- Cervical spinal cord injury
- Intensive care