Masalah pada sistem respirasi merupakan komplikasi yang sering menyebabkan morbiditas dan mortalitas pada pasien dengan Spinal Cord Injury (SCI) baik pada fase akut maupun kronik. Hal tersebut disebabkan adanya kelumpuhan otot-otot inspirasi dan ekspirasi yang motor neuronnya berasal dari nervus spinalis C3–C5, melemahnya refleks batuk dan stagnansi sekret. Cedera tulang belakang servikal dapat terjadi baik langsung maupun tidak langsung, dapat menyebabkan defisit neurologis ataupun kematian. Cedera medula spinalis servikal terjadi 2–3% dari seluruh kejadian cedera dan 8,2% dari semua cedera yang menyebabkan kematian. Pada artikel ini disajikan kasus pasien dengan SCI setinggi C3–C6, pasien menjalani operasi laminektomi dekompresi. Pascaoperasi pasien dirawat di ICU dikontrol menggunakan ventilator dengan mode Synchronized Intermittent Mandatory Ventilation (SIMV). Setelah pasien diekstubasi, saturasi turun, dari pemeriksaan fisik didapatkan ronkhi minimal, pasien didiagnosis dengan Hospital-Acquired Pneumonia (HAP) dan sepsis. Saturasi pasien membaik menjadi 99% setelah direintubasi disertai dengan program nebul combivent dan bisolvon 20 tetes/6 jam. Weaning ventilator pada pasien ditunda. Pasien diberikan vancomysin dan meropenem sebagai antibiotik definitif setelah dilakukan kultur bakteri. Respiration Problems in Cervical Spine Injury Patients Abstract Respiratory complications associated with spinal cord injury (SCI) are the most important cause of morbidity and mortality in both the acute phase and a long-term perspective. This is due to paralysis of the inspiratory and expiratory muscles whose motor neurons originate from the C3–C5 spinal nerves, weakened cough reflexes and stagnation of secretions. Cervical spinal cord injuries can occur directly or inderectly that can cause neurological disorder or death. Cervical injuries occur 2–3% of all cedera events and 8,2% of all cederas that cause of death. In this article, we present a case of a patient with SCI at C3–C6, a patient undergoing decompressive laminectomy surgery. Postoperation, the patient was treated in the ICU controlled using a ventilator with Synchronized Intermittent Mandatory Ventilation (SIMV) mode. After the patient was extubated, the saturation dropped, on physical examination, there were minimal rhonchi, the patient was diagnosed with Hospital-Acquired Pneumonia (HAP) and sepsis. Patient saturation improved to 99% after reintubation accompanied by nebul combivent program and bisolvon 20 drops every 6 hours. Ventilator weaning in patient was delayed. The patient was given vancomycin and meropenem as definitive antibiotics after bacterial culture was performed.
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