Cardiovascular reflexes in tracheostomised tetraplegics

Abstract

A patient with acute traumatic tetraplegia associated with severe bleeding from multiple peptic ‘stress ulcers’ is described. He was treated with blood transfusions (35 pints in one week) but his condition deteriorated after a pulmonary embolism and a tracheostomy was performed. Subsequently he had periods of cardiac arrest every time his tracheostomy was sucked out. Atropine prevented this, and the mechanism of the cardiac arrest is assumed to be vago-vagal. The patient died the next day. Seven patients with high traumatic spinal cord lesions and tracheostomies (6 cervical, I upper dorsal) had ECGs performed before, during and after endotracheal suction. No arrythmias developed. The mechanism of the cardiac arrest in this case is discussed with particular reference to the association with ‘stress ulcers’ and pulmonary embolism. © 1965, International Spinal Cord Society. All rights reserved.