{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,8]],"date-time":"2026-06-08T12:42:56Z","timestamp":1780922576802,"version":"3.54.1"},"reference-count":19,"publisher":"BMJ","issue":"1","license":[{"start":{"date-parts":[[2025,1,3]],"date-time":"2025-01-03T00:00:00Z","timestamp":1735862400000},"content-version":"unspecified","delay-in-days":2,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Trauma Surg Acute Care Open"],"accepted":{"date-parts":[[2024,12,5]]},"published-print":{"date-parts":[[2025,1]]},"abstract":"<jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Patients with cervical spinal cord injuries (CSCIs) have a high incidence of respiratory complications. The effectiveness of non-invasive positive pressure ventilation (NPPV) in preventing respiratory complications such as pneumonia in acute CSCIs remains unclear. We evaluated whether intermittent NPPV (iNPPV) could prevent pneumonia in patients with acute CSCIs.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>This single-center, retrospective study evaluated patients diagnosed with CSCIs with American Spinal Injury Association Impairment Scale scores of A\u2013C between January 2012 and December 2022. Patients were categorized based on receipt of iNPPV into the iNPPV and usual care groups. Prophylactic iNPPV was defined as the initiation of iNPPV within 72\u2009hours of admission. The primary outcome was the development of pneumonia. The secondary outcomes were other respiratory complications (tracheal intubation and tracheostomy) and adverse events (delirium and vomiting). The groups were compared with regard to outcomes after adjustment for patient backgrounds using inverse probability of treatment weighting (IPTW) with propensity scores.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Of the 213 patients during the study period, 94 were included. Of these, 61 (64.9%) received prophylactic iNPPV. The incidence of pneumonia was 27.9% in the iNPPV group and 48.5% in the usual care group in the unadjusted cohort. In the propensity score analysis using IPTW, the iNPPV group showed a lower incidence of pneumonia than the usual care group (29.0% vs 56.5%, p&lt;0.001). Tracheal intubation and tracheostomy were less common in the iNPPV group than those in the usual care group (10.6% vs 29%; p=0.001\u2009and 10.6% vs 27.1%; p=0.003, respectively). The incidences of delirium and vomiting did not increase in the iNPPV group.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Prophylactic iNPPV was associated with a lower incidence of pneumonia in patients with acute CSCIs.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Level of evidence<\/jats:title>\n                  <jats:p>\u2163.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/tsaco-2024-001631","type":"journal-article","created":{"date-parts":[[2025,1,4]],"date-time":"2025-01-04T23:15:22Z","timestamp":1736032522000},"page":"e001631","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Association between prophylactic intermittent non-invasive positive pressure ventilation and incidence of pneumonia in patients with cervical spinal cord injury: a retrospective single-center cohort study"],"prefix":"10.1136","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3809-1572","authenticated-orcid":false,"given":"Yuita","family":"Fukuyama","sequence":"first","affiliation":[{"name":"Department of Shock and Trauma Center, Nippon Medical School Chiba Hokusoh Hospital, Inzai, Chiba 2701694, Japan"},{"name":"Department of Emergency and Critical Care Medicine, Nippon Medical School, Bunkyo-ku, Tokyo 1138603, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1825-1759","authenticated-orcid":false,"given":"Kazuhiro","family":"Okada","sequence":"additional","affiliation":[{"name":"Department of Shock and Trauma Center, Nippon Medical School Chiba Hokusoh Hospital, Inzai, Chiba 2701694, Japan"},{"name":"Department of Emergency and Critical Care Medicine, Nippon Medical School, Bunkyo-ku, Tokyo 1138603, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takashi","family":"Tagami","sequence":"additional","affiliation":[{"name":"Department of Emergency and Critical Care Medicine, Nippon Medical School, Bunkyo-ku, Tokyo 1138603, Japan"},{"name":"Department of Emergency and Critical Care Medicine, Nippon Medical School Musashikosugi Hospital, Kawasaki, Kanagawa 2118533, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoshiaki","family":"Hara","sequence":"additional","affiliation":[{"name":"Department of Shock and Trauma Center, Nippon Medical School Chiba Hokusoh Hospital, Inzai, Chiba 2701694, Japan"},{"name":"Department of Emergency and Critical Care Medicine, Nippon Medical School, Bunkyo-ku, Tokyo 1138603, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shoji","family":"Yokobori","sequence":"additional","affiliation":[{"name":"Department of Emergency and Critical Care Medicine, Nippon Medical School, Bunkyo-ku, Tokyo 1138603, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2025,1,4]]},"reference":[{"key":"2025081711025596000_10.1.e001631.1","doi-asserted-by":"publisher","DOI":"10.1038\/sc.2011.178"},{"key":"2025081711025596000_10.1.e001631.2","first-page":"67","article-title":"Risk factors for mortality in traumatic cervical spinal cord injury: Brazilian data","volume":"67","author":"Neumann","year":"2009","journal-title":"J Trauma"},{"key":"2025081711025596000_10.1.e001631.3","doi-asserted-by":"publisher","DOI":"10.1016\/j.resp.2009.04.002"},{"key":"2025081711025596000_10.1.e001631.4","doi-asserted-by":"publisher","DOI":"10.1080\/10790268.2007.11753946"},{"key":"2025081711025596000_10.1.e001631.5","doi-asserted-by":"crossref","first-page":"397","DOI":"10.1016\/j.pmr.2020.03.006","article-title":"Noninvasive Respiratory Management of Spinal Cord Injury","volume":"31","author":"Bach","year":"2020","journal-title":"Phys Med Rehabil Clin 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Ventilation","volume":"195","author":"Chan","year":"2017","journal-title":"Lung"},{"key":"2025081711025596000_10.1.e001631.17","doi-asserted-by":"crossref","first-page":"1824","DOI":"10.1089\/neu.2013.2975","article-title":"Onset, risk factors, and impact of delirium in patients with traumatic spinal cord injury","volume":"30","author":"Cheung","year":"2013","journal-title":"J Neurotrauma"},{"key":"2025081711025596000_10.1.e001631.18","doi-asserted-by":"publisher","DOI":"10.1007\/s001340050438"},{"key":"2025081711025596000_10.1.e001631.19","doi-asserted-by":"crossref","first-page":"1626","DOI":"10.1007\/s00134-017-4785-1","article-title":"Intermittent noninvasive ventilation after extubation in patients with chronic respiratory disorders: a multicenter randomized controlled trial (VHYPER)","volume":"43","author":"Vargas","year":"2017","journal-title":"Intensive Care Med"}],"container-title":["Trauma Surgery &amp; Acute Care 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