Weaning Complete Cervical Cord Injury Patients from Mechanical Ventilator Support? A Case Series

The purpose of this case series report is to explain the different strategies followed in weaning the cervical cord injury patients from ventilator. Case I A 53-year-old female admitted with history of fall on 01/04/14 with C3-C4 grade III subluxation. C4 corpectomy with C3-5 fusion was done. Chest physiotherapy comprising of percussion, vibration, manual hyperinflation and suctioning was done every 4 hours. Inspiratory muscle training with manual facilitation, Power Breathe, and inspiratory spirometer was done regularly and patient was removed from ventilator on regular intervals. After 8 months, the patient was completely weaned from ventilator. Case II A 57-year-old male admitted with traumatic C4-5 and C5-C6 PIVD. C4-5 and C5-6 microdiscectomy and reduction stabilization of C4-C5 subluxation. One year after the trauma, patient was admitted in the hospital and decannulated. The Cough was facilitated with cough assistive devices and manual facilitation. Conclusion Based on the case series it is observed that patients with high cervical cord injury can be weaned from ventilator and can be de-cannulated if the patient was provided intensive inspiratory muscle training using various types of inspiratory muscle training devices and training methods as well as facilitating cough capacity by use of cough assist devices.