Article

This was a prospective observational study.Objectives:To review
airway management of patients with acute cervical spinal cord injury (CSCI) who
are admitted to the intensive care unit (ICU) and to develop a classification and
regression tree (CART) to direct clinical decision making in airway management.
SETTING: This study was carried out in Australia. METHODS: All patients with CSCI
who required intubation and mechanical ventilation and who were admitted to ICU
in three tertiary hospitals in Melbourne between October 2004 and May 2009 and
two other interstate hospitals between December 2004 and December 2005 were
included. Airway management was recorded. RESULTS: A total of 114 patients were
included. Tracheostomy insertion occurred in 68 patients (59.7%). Using CART
analysis, it was found that the variables forced vital capacity, the volume of
pulmonary secretion and gas exchange were predictive of airway management on
82.3% occasions with an 8.7% extubation failure rate. CONCLUSION: A CART can be
useful in clinical decision making regarding airway management in CSCI.

Langue : ANGLAIS