Complications Resulting from the Use of Cervical Collars in the Context of Trauma: an integrative literature review

Resumo

Introdução: O colar cervical é um dispositivo amplamente utilizado na imobilização da coluna cervical em vítimas de trauma, visando a prevenção de lesões neurológicas secundárias. No entanto, seu uso prolongado ou inadequado pode desencadear diversas complicações clínicas. Objetivo: Analisar as principais complicações decorrentes do uso do colar cervical em pacientes traumatizados. Métodos: A busca foi realizada nas bases PubMed e Google Scholar, utilizando os descritores “Cervical collar AND Trauma AND Complications”. Foram incluídos estudos originais publicados nos últimos 10 anos, nas línguas portuguesa e inglesa, que abordassem complicações associadas ao uso do colar cervical. Após a aplicação dos critérios de elegibilidade, oito estudos foram selecionados, incluindo sete transversais e um ensaio clínico randomizado. Resultado: Foram apontados quatro principais grupos de complicações: neurológicas, dermatológicas, respiratórias e disfagia. Entre as neurológicas, destacaram-se o aumento da sensibilidade dolorosa e elevação da pressão intracraniana. As dermatológicas incluíram úlceras por pressão, com maior prevalência em idosos e em casos de uso prolongado. No aspecto respiratório, foram observadas reduções nos volumes pulmonares, comprometimento da capacidade vital e aumento da incidência de pneumonia. A disfagia também foi relatada, com impacto na alimentação, hidratação e qualidade de vida. Conclusão: Apesar da importância do colar cervical na proteção da coluna, é fundamental a sua utilização criteriosa, com monitoramento contínuo, a fim de reduzir os riscos e otimizar os desfechos clínicos dos pacientes.

Palavras-chave

Traumatismos da medula espinal; Colar cervical; Complicações relacionadas a dispositivos

Abstract

Introduction: The cervical collar is a device widely used for immobilizing the cervical spine in trauma victims, aiming to prevent secondary neurological injuries. However, its prolonged or inadequate use can trigger several clinical complications. Objective: To analyze the main complications resulting from the use of the cervical collar in trauma patients. Methods: The search was performed in the PubMed and Google Scholar databases, using the descriptors “Cervical collar AND Trauma AND Complications”. Original studies published in the last 10 years, in Portuguese and English, that addressed complications associated with the use of the cervical collar were included. After applying the eligibility criteria, eight studies were selected, including seven cross-sectional studies and one randomized clinical trial. Results: Four main groups of complications were identified: neurological, dermatological, respiratory and dysphagia. Among the neurological complications, increased pain sensitivity and elevated intracranial pressure stood out. Dermatological complications included pressure ulcers, with a higher prevalence in the elderly and in cases of prolonged use. In the respiratory aspect, reductions in lung volumes, impairment of vital capacity and an increased incidence of pneumonia. Dysphagia was also reported, with an impact on nutrition, hydration and quality of life. Conclusion: Despite the importance of the cervical collar in protecting the spine, its judicious use, with continuous monitoring, is essential in order to reduce risks and optimize clinical outcomes for patients.

Keywords

Spinal cord injuries; Cervical collar; Device-related complications

References

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