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European Journal of Physical and Rehabilitation Medicine 2010 March;46(1):37-42

Copyright © 2010 EDIZIONI MINERVA MEDICA

language: English

Lower respiratory events in seated tracheotomized tetraplegic patients

Médée B. 1, 2, Girard R. 3, Loukili A. 1, 2, Loiseau K. 1, 2, Tell L. 1, 2, Rode G. 1, 2

1 University of Lyon 1, Inserm UMR-S 864, Bron, France; 2 Civil Hospices of Lyon, Service of Physical Medicine and Rehabilitation, Henry Gabrielle Hospital, Saint-Genis-Laval, France; 3 Civil Hospices of Lyon, Unit of Hygiene and Epidemiology, Lyon Sud Hospital Centre, Pierre Bénite Cedex, France;


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AIM: Retrospective study on the changing position impact on respiratory events in 14 rehabilitation tracheotomized tetraplegic patients, during 25 months.
METHODS: Three positions were compared: permanently supine (16 periods), seated on ≤5 days/week (20 periods), or seated on ≥6 days/week (10 periods). The end-point was the incidence of the following respiratory events: pneumonia, atelectasis and plugging of tracheal/bronchial secretions. Patients were considered as their own control but data were pooled for analysis.
RESULTS: Pneumonia and plugging incidences were significantly higher in the permanently supine position than in the seated ≤5 days position (P≤0.001). Incidence was not significant higher in the seated ≤5 days than in the seated ≥6 days position. Atelectasis occurred only in the supine position.
CONCLUSION: Plugging prevalence was significantly higher in the permanently supine position (53.3%) than in the seated ≤5 days position (21.6%, P<10-5), and in the seated ≤5 days position (21.6%) than in the seated ≥6 days position (14.6%, P=0.001).

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