{Reference Type}: Journal Article
{Title}: Management of acute cervical spinal cord injury in the non-specialist intensive care unit: a narrative review of current evidence.
{Author}: Wiles MD;Benson I;Edwards L;Miller R;Tait F;Wynn-Hebden A;
{Journal}: Anaesthesia
{Volume}: 79
{Issue}: 2
{Year}: 2024 Feb 13
{Factor}: 12.893
{DOI}: 10.1111/anae.16198
{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.