Traumatic tetraplegia: noninvasive respiratory management in the acute setting.

A 15-yr-old patient with high-level spinal cord injury developed ventilatory failure 24 hr after hospital admission and required continuous ventilatory support. Although he lost all ventilator-free breathing tolerance, he was managed by receiving noninvasive intermittent positive-pressure ventilation rather than intermittent positive-pressure ventilation via an endotracheal intubation. Cooperative, uncomplicated, acutely injured patients with spinal cord injury who develop ventilatory failure are candidates to use noninvasive intermittent positive-pressure ventilation to avoid intubation.