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Respiratory Management (Rehab Phase)

Other Pharmaceuticals

There are many other medications with potential benefit for the treatment of pulmonary function in SCI. The use of anticoagulants for the prevention of deep vein thrombosis and pulmonary emboli is covered in Chapter 15. Other medications used in the treatment of asthma and/or chronic obstructive pulmonary disease such as cromolyn sodium, methylxanthines and inhaled corticosteroids have not been studied in SCI.

Author Year; Country
Score
Research Design
Total Sample Size
Methods Outcome

Li et al. 2012; China
PEDro=6
Randomized clinical trial
N=61

Population: N=61 participants with acute C-SCI (AIS A and B) randomly divided into 2 groups: high-dose ambroxol group (n=27) and control group (n=34).
High dose ambroxol: 17M 10F; mean(SD) age: 56.1(11.2).
Control group: 23M 11F; mean (SD) age: 53.0(13.6).
Treatment: Treatment group received intravenous ambroxol at 990 mg/day for 5 consecutive days after operation; the control group did not receive any treatment.
Outcome measures: Oxygenation index, pulmonary complications.
  1. The group treated with high-dose ambroxol showed a lower rate of postoperative pneumonia and hypoxemia within 5 days after operation.
  2. On the 3rd and 5rd days, the oxygenation index in the high-dose ambroxol group (291.02(34.96) and 301.28(37.69)) was significantly higher than in the control group (230.08(26.25) and 253.82(26.26)) with significant differences between the two groups.

Discussion

Ambroxol is a mucolytic medication that is used in the treatment of respiratory diseases associated with excessive mucus. There is one RCT (Li et al. 2012) that shows that high-dose IV ambroxol after surgical cervical spinal cord decompression and stabilization reduces the rate of postoperative pneumonia and increases blood oxygenation.

Conclusion

There is level 1b evidence (based on 1 RCT: Li et al. 2012) that high-dose IV ambroxol after surgery increases blood oxygenation in cervical spinal cord injured patients with motor complete injuries.

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