ANTIBACTERIAL THERAPY OF BRONCHOPULMONARY COMPLICATIONSIN PATIENTS WITH CERVICAL SPINE INJURY

Abstract

Objective. To analyze outcomes in patients with bronchopulmonary complications in acute and early periods of the spine and spinal cord injury whose treatment was based on optimal approach to antibacterial therapy.

Material and Methods. Sixty patients (54 males and 6 females) with sequelae of complicated cervical spine and spinal cord injury were examined. Mean age of patients was 24.0 ± 7.5 years. Bronchopulmonary complications occurred in 48 (80.0 %) patients. Endobronchitis was complicated by pneumonia in 34 (70.1 %) cases. Examination included clinical and neurological, radiological, endoscopic, bacteriological and cytological methods.

Results. Radiological and endoscopic examination detected diffuse bilateral grade I—III endobronchitis in 18 patients from groups I and II. Bronchopulmonary complications in patients from the group III included tracheitis (4 cases) and grade III endobronchitis (20 cases). Patients from group IV had aspiration pneumonia. Variants of antibacterial therapy of infectious complications were offered accounting for causative agents, severity grade, and specifics of the injury.

Conclusion. The application of early and rational antibacterial therapy of bronchopulmonary complications allows pathological process being stopped at the level of multiple organ dysfunction, to prevent multiple organ failure, and to reduce the intensive care unit length of stay.