Skip to main content
British Medical Journal (Clinical Research Ed.) logoLink to British Medical Journal (Clinical Research Ed.)
. 1985 Dec 7;291(6509):1620–1622. doi: 10.1136/bmj.291.6509.1620

Ventilation or dignified death for patients with high tetraplegia.

B P Gardner, F Theocleous, J W Watt, K R Krishnan
PMCID: PMC1418404  PMID: 3935213

Abstract

The case histories of the 37 patients of the Mersey Regional Spinal Injuries Centre who were artificially ventilated between 1968 and 1984 were reviewed. The patients and caring relatives were interviewed separately to determine their views. Of 21 patients who were still alive, 18 said that they would wish to be temporarily ventilated again if the need arose, two were undecided, and one said that she would wish to be allowed to die. Sixteen caring relatives said that they were glad that the decision to ventilate had been taken. Those who were not glad were all young mothers. The outcome from any combination of factors that existed before injury could not be predicted except that most patients over age 59 fared badly. Patients with spinal cord damage should be artificially ventilated if required, provided that this can be carried out well and that total emotional, educational, and physical support can be provided and maintained. Whether or not scarce resources should be deployed in this manner requires discussion.

Full text

PDF
1620

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Donovan W. H., Taylor N. Ventilatory assistance in quadriplegia. Arch Phys Med Rehabil. 1973 Oct;54(10):485–488. [PubMed] [Google Scholar]
  2. Glenn W. W., Hogan J. F., Phelps M. L. Ventilatory support of the quadriplegic patient with respiratory paralysis by diaphragm pacing. Surg Clin North Am. 1980 Oct;60(5):1055–1078. doi: 10.1016/s0039-6109(16)42233-4. [DOI] [PubMed] [Google Scholar]
  3. Gross D., Ladd H. W., Riley E. J., Macklem P. T., Grassino A. The effect of training on strength and endurance of the diaphragm in quadriplegia. Am J Med. 1980 Jan;68(1):27–35. doi: 10.1016/0002-9343(80)90157-6. [DOI] [PubMed] [Google Scholar]
  4. Huldtgren A. C., Fugl-Meyer A. R., Jonasson E., Bake B. Ventilatory dysfunction and respiratory rehabilitation in post-traumatic quadriplegia. Eur J Respir Dis. 1980 Dec;61(6):347–356. [PubMed] [Google Scholar]
  5. Splaingard M. L., Frates R. C., Jr, Harrison G. M., Carter R. E., Jefferson L. S. Home positive-pressure ventilation. Twenty years' experience. Chest. 1983 Oct;84(4):376–382. doi: 10.1378/chest.84.4.376. [DOI] [PubMed] [Google Scholar]

Articles from British Medical Journal (Clinical research ed.) are provided here courtesy of BMJ Publishing Group

RESOURCES