The feasibility of using mouthpiece ventilation in the intensive care unit for post-extubation breathing support after acute tetraplegia

Spinal Cord, 2023 · DOI: https://doi.org/10.1038/s41393-023-00889-z · Published: March 17, 2023

Spinal Cord Injury Critical Care Pulmonology

Simple Explanation

This study explores using a mouthpiece to provide breathing support for patients with acute tetraplegia after they are removed from a ventilator in the intensive care unit (ICU). The researchers wanted to see if this method, called mouthpiece ventilation (MPV), was practical and helpful for these patients. They looked at how easy it was to use, how well patients tolerated it, and the amount of support needed to make it work effectively.

Study Duration

14 months

Participants

14 participants with acute tetraplegia

Evidence Level

Level 2; Prospective cohort study

Key Findings

1
MPV is feasible for post-extubation support in acute CSCI patients in the ICU.
2
Pressure control mode MPV was found to be the most suitable.
3
Significant clinical support is needed to educate both the patient and clinicians.

Research Summary

This study investigated the feasibility of using mouthpiece ventilation (MPV) for post-extubation breathing support in acute cervical spinal cord injury (CSCI) patients in the ICU. The results indicated that MPV is a feasible option, well-accepted by patients and clinicians, and can be a useful adjunct to ICU treatment. The study also highlighted the importance of pressure control mode MPV and the need for intensive clinical support to ensure effective implementation.

Practical Implications

Clinical Practice

MPV can be considered as a viable alternative or complementary therapy to other forms of non-invasive ventilation for acute CSCI patients in the ICU.

Education and Training

Healthcare providers should receive comprehensive education and training on MPV implementation, including patient selection, device setup, and titration strategies.

Future Research

Larger studies are warranted to determine the effectiveness of MPV in reducing pulmonary complications, ICU LOS, and extubation failure in this patient population.

Study Limitations

1
Small sample size limits the generalizability of the findings.
2
Study was conducted at a single center, which may not reflect practices at other institutions.
3
The study did not record specific intensity of MPV delivered.

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