198
CHAPTER 17
FIGS, icoa and b. Traumatic paraplegia below 04. Patient admitted with profound
surgical emphysema of the face due to displacement and blockage of the tracheostomy
tube. From H. Frankel, 1968
(Paraplegia
5, 228).
Cardio-Vascular Reflexes.
Another serious complication in tracheostomized patients
are cardio-vascular reflexes elicited by endotracheal suction and inflation of endotracheal
cuffs. These have been reported by several authors as occurring in non-paraplegic
patients, consisting of arrhythmias caused by suction and inflation of endotracheal cuffs
(Reid & Brace, 1940), and sudden death has been reported by Davis
et al.
(1953), Nelson
(1957)5 Green (1959), and Stephenson (1958) reviewed reports of death from cardio
vascular reflexes. Dollfus & Frankel (1965) reported these reflexes in a tracheostomised
case with a complete lesion C4/6, in whom attacks of cardiac arrest were elicited by
inflating the cuffed tracheostomy tube and endotracheal suction to keep the airway free.
