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Safe transition to independent breathing after spinal cord injury in ICU research

17 December 2021

PA Hospital Intensive care unit is testing an evidence-based bedside decision support tool to guide clinicians in assisting patients with acute cervical spinal cord injury to successfully take their first breath without a ventilator.

“One in five patients with acute cervical spinal cord injury fail their first attempt to breathe without a ventilator, resulting in increased ICU length of stay and delayed rehabilitation,” said PAH Physiotherapist and study lead, Isabella Lane.

“We are exploring the effectiveness of this bedside decision support tool to reduce the risk of extubation failure.”

Co-investigator and senior Physiotherapist, Alicia Agli agrees that evidence-based resources are crucial to empower clinicians and standardising the decision support tool will give them confidence to deliver safe and consistent care to this complex patient population.

“Facilitating independent breathing for a patient in this group requires sound judgment and experience to optimise the patient’s overall long-term trajectory.

“Preliminary evaluation of the tool in a simulated activity has determined the tool can improve staff confidence, particularly for staff with less ICU experience, and act as a step-by-step guide to approaching the multidisciplinary team decision to move a patient to independent breathing,” she said.

PA Hospital is an ideal location for this study to be conducted.

“Patients with acute cervical spinal cord injury are often admitted to the PAH due to the co-location of the Spinal Injuries Unit on campus, and PAH is the Queensland specialist centre for acute spinal cord injury assessment, management and rehabilitation with other hospitals referring to us for advice and expertise,” Alicia said.

The study is funded by a Trauma and Disaster Management research grant by the National Critical Care and Trauma Response Centre Trust Fund awarded to Isabella at the 2020 Metro South Health Research awards.

The first phase of the project in a controlled simulated setting is now complete with the study now moving to observe the tool in use in ICU and monitor effects on patient outcomes over a 12-month period.

Last updated 17 December 2021
Last reviewed 17 December 2021

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