Management of acute cervical spinal cord injury in the non‐specialist intensive care unit: a narrative review of current evidence

Wiles, M. D.; Benson, I.; Edwards, L.; Miller, R.; Tait, F.; Wynn-Hebden, A.

Abstract

Each year approximately one million people suffer spinal cord injury, which has significant physical, psychosocial and economic impacts on patients and their families. Spinal cord rehabilitation centres are a well-established part of the care pathway for patients with spinal cord injury and facilitate improvements in functional independence and reductions in healthcare costs. Within the UK, however, there are a limited number of spinal cord injury centres, which delays admission. Patients and their families often perceive that they are not receiving specialist care while being treated in non-specialist units. This review aimed to provide clinicians who work in non-specialist spinal injury centres with a summary of contemporary studies relevant to the critical care management of patients with cervical spinal cord injury. We undertook a targeted literature review including guidelines, systematic reviews, meta-analyses, clinical trials and randomised controlled trials published in English between 1 June 2017 and 1 June 2023. Studies involving key clinical management strategies published before this time, but which have not been updated or repeated, were also included. We then summarised the key management themes: acute critical care management approaches (including ventilation strategies, blood pressure management and tracheostomy insertion); respiratory weaning techniques; management of pain and autonomic dysreflexia; and rehabilitation.

Citation

Wiles, M. D., Benson, I., Edwards, L., Miller, R., Tait, F., & Wynn-Hebden, A. (2024). Management of acute cervical spinal cord injury in the non‐specialist intensive care unit: a narrative review of current evidence. Anaesthesia, 79(2), 193-202. https://doi.org/10.1111/anae.16198

• Journal Article Type: Review
• Acceptance Date: Nov 23, 2023
• Online Publication Date: Dec 13, 2023
• Publication Date: 2024-02
• Deposit Date: Feb 9, 2024
• Publicly Available Date: Feb 9, 2024
• Journal: Anaesthesia
• Print ISSN: 0003-2409
• Electronic ISSN: 1365-2044
• Publisher: Wiley
• Peer Reviewed: Peer Reviewed
• Volume: 79
• Issue: 2
• Pages: 193-202
• DOI: https://doi.org/10.1111/anae.16198
• Keywords: rehabilitation medicine, intensive care medicine, neurological injury, clinical management, spinal cord injury
• Public URL: https://nottingham-repository.worktribe.com/output/28701990
• Publisher URL: https://associationofanaesthetists-publications.onlinelibrary.wiley.com/doi/10.1111/anae.16198
• Additional Information: Accepted: 2023-11-23; Published: 2023-12-13