Aspiration pneumonia after spinal cord injury. Placement of PEG tubes as effective prevention

• Published in: Der Unfallchirurg 2012-05, Vol.115 (5), p.427-432
• Main Authors: Ramczykowski, T, Grüning, S, Gurr, A, Muhr, G, Horch, C, Meindl, R, Swol, J
• Format: Article
• Language: ger
• Subjects: Adolescent; Adult; Aged; Aged, 80 and over; Child; Deglutition Disorders - etiology; Deglutition Disorders - rehabilitation; Enteral Nutrition - instrumentation; Female; Humans; Male; Middle Aged; Pneumonia, Aspiration - etiology; Pneumonia, Aspiration - prevention & control; Spinal Cord Injuries - complications; Spinal Cord Injuries - rehabilitation; Treatment Outcome; Young Adult
• ISSN: 1433-044X
• DOI: 10.1007/s00113-010-1889-2

Pulmonary infections are dreaded complications in acute spinal cord injuries. The prevention of pneumonia is essential for reducing mortality and the period of hospitalization. Swallowing disorders occur frequently in patients with cervical cord injuries and are accompanied by aspiration with a high risk of pneumonia. In this study the identification and analysis of patients with newly acquired cervical cord injuries were carried out with respect to respiratory complications, treatment and prevention. A total of 27 patients with a cervical cord injury (tetraplegia) were identified. Of these 20 patients (74%) were identified with a swallowing disorder and a high risk of aspiration. Of these patients 11 (PEG group) received a percutaneous feeding tube (PEG tube), 9 patients (non-PEG group) with diagnosed dysphagia were treated without PEG tube. A total of 6 patients in the non-PEG group (67%) acquired pneumonia compared to 3 patients (27%) in the PEG group. A swallowing disorder is a major risk factor for a pulmonary infection after a cervical cord injury. An early placement of a PEG tube has a preventive effect with respect to aspiration pneumonia in patients with dysphagia.