Document Detail


Airflow obstruction and reversibility in spinal cord injury: evidence for functional sympathetic innervation.
MedLine Citation:
PMID:  19061747     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: The first objective was to assess group differences for specific airway conductance (sGaw) among subjects with tetraplegia, high paraplegia (HP: T2-T6), and low paraplegia (LP: T10-L4). The second objective was to determine the significance of responsiveness to ipratropium bromide (IB) by the assessment of the inherent variability of baseline measurements for impulse oscillation (IOS), body plethysmography, and spirometry. DESIGN: Prospective cross-sectional intervention study. SETTING: James J. Peters Veterans Administration Medical Center. PARTICIPANTS: Subjects (N=43): 12 with tetraplegia (C4-8), 11 with HP, 11 with LP, and 9 controls. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Measurement of IOS, body plethysmography, and spirometry parameters at baseline and 30 minutes after IB. RESULTS: Baseline sGaw was significantly lower in tetraplegia (0.14+/-0.03) compared with HP (0.19+/-0.05) and LP (0.19+/-0.04) patients. By use of minimal difference to evaluate IB responsiveness in tetraplegia, 4 of 12 and 12 of 12 subjects had significant increases in forced expiratory volume in 1 second and sGaw, respectively, whereas 11 of 12 and 10 of 12 subjects had significant decreases in respiratory resistances measured at 5 and 20 Hz (R5 and R20), respectively. CONCLUSIONS: The finding of group differences for baseline sGaw supports the hypothesis that human lung contains functional sympathetic innervation. Body plethysmography and IOS were comparable in detecting IB-induced bronchodilation in tetraplegia and significantly more sensitive than spirometry.
Authors:
Miroslav Radulovic; Gregory J Schilero; Jill M Wecht; Joseph P Weir; Ann M Spungen; William A Bauman; Marvin Lesser
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Publication Detail:
Type:  Comparative Study; Evaluation Studies; Journal Article; Research Support, U.S. Gov't, Non-P.H.S.    
Journal Detail:
Title:  Archives of physical medicine and rehabilitation     Volume:  89     ISSN:  1532-821X     ISO Abbreviation:  Arch Phys Med Rehabil     Publication Date:  2008 Dec 
Date Detail:
Created Date:  2008-12-08     Completed Date:  2009-01-23     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  2985158R     Medline TA:  Arch Phys Med Rehabil     Country:  United States    
Other Details:
Languages:  eng     Pagination:  2349-53     Citation Subset:  AIM; IM    
Affiliation:
Veterans Affairs Rehabilitation Research and Development Service, Center of Excellence for the Medical Consequences of Spinal Cord Injury, Department of Medicine, The James J. Peters VA Medical Center, Bronx, NY 10468, USA. Miroslav.Radulovic@va.gov
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MeSH Terms
Descriptor/Qualifier:
Adult
Airway Obstruction / drug therapy,  etiology,  physiopathology*
Bronchi / innervation*
Bronchodilator Agents / pharmacology
Case-Control Studies
Cholinergic Antagonists / pharmacology*
Cross-Sectional Studies
Humans
Ipratropium / pharmacology
Muscle, Smooth / innervation*
Paraplegia / complications,  physiopathology*,  rehabilitation
Plethysmography
Prospective Studies
Quadriplegia / complications,  physiopathology*,  rehabilitation
Respiratory Function Tests / methods
Sensitivity and Specificity
Spinal Cord Injuries / complications,  physiopathology*,  rehabilitation
Spirometry
Sympathetic Nervous System / drug effects*
Chemical
Reg. No./Substance:
0/Bronchodilator Agents; 0/Cholinergic Antagonists; 60205-81-4/Ipratropium

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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