Decannulation and non-invasive ventilation in a male patient with traumatic spinal cord injury: a case report

Abstract

Patients with traumatic spinal cord injury can develop complex respiratory impairment, with alterations in their respiratory mechanics that may range from a reduction in lung capacity secondary to muscle weakness to a complete absence of respiratory muscle activity. These patients may experience respiratory failure and require mechanical ventilation for prolonged periods, as well as undergoing a tracheostomy during mechanical ventilation in their hospital stay. They often face difficulty weaning off mechanical ventilation and, in many cases, require partial or total home ventilatory assistance, usually invasively through a tracheostomy. This case report presents the experience of a 55-year-old male patient who suffered a motorcycle accident after his vehicle became entangled in an electrical wire hanging over a public road, resulting in a cervical injury at the C5-C6 level. He had a hospital stay of 56 days, required invasive mechanical ventilation, and was tracheostomized on the second day of admission. The patient was partially weaned from mechanical ventilation, decannulated 47 days after the accident, and later discharged home with partial noninvasive mechanical ventilation and cough assistance using a mechanical cough assist device. Decannulation in patients with high spinal cord injury and subsequent home management with non-invasive mechanical ventilation and mechanical cough assistance can not only represent the preservation of the individual's respiratory autonomy but also improve respiratory reserve and capacity to face the physical rehabilitation process, positively impacting the quality of life of both the patient and their family environment.