Reflections on the intensive care of 106 acute cervical spinal cord injury patients in the resuscitation unit of a general traumatology centre

Abstract

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.