Document Detail

Pulmonary Function and Expiratory Flow Limitation in Acute Cervical Cord Injury.
MedLine Citation:
PMID:  22543017     Owner:  NLM     Status:  Publisher    
OBJECTIVE: To identify the nature of the changes of respiratory mechanics in patients with middle cervical SCI and their correlation with posture. DESIGN: Clinical trial SETTING: Acute Spinal Cord Injury Unit PARTICIPANTS: Thirty four patients with SCI at C4-C5 level studied within 6 months of injury. INTERVENTION: Patients were assessed by NEP test, maximal static respiratory pressure and standard spirometry. MAIN OUTCOME MEASURES: The following respiratory variables were recorded, both in semirecumbent and supine position: 1) Tidal expiratory flow limitation (TEFL); 2) airways resistances; 3) mouth occlusion pressure developed 0.1 second (P(0.1)) after occluded inspiration;4) maximum inspiratory (MIP) and maximum expiratory (MEP) pressure; 5) spirometric data. RESULTS: a) TEFL was detected in 32% of the patients in supine and in 9% in semirecumbent position; b) Airway resistances and P(0.1) were much higher compared to normal values whilst MIP and MEP were markedly reduced; e) FEV(1)/FVC was less than 70%, while the other spirometric data were reduced up to 30% of predicted values. CONCLUSION: Patients with middle cervical SCI can develop TEFL. The presence of TEFL, associated with increased airway resistance, could rise in work of breathing in presence of a reduced capacity of the respiratory muscles to face the increased load. The semirecumbent position and the use of CPAP can be helpful in order to 1) reduce the extent of TEFL and to avoid the opening/closure of the small airway; 2) decrease airway resistance; 3) maintain the expiratory flow as high as possible, favoring removal of secretions.
Valentina Alvisi; Elisabetta Marangoni; Silvia Zannoli; Mariella Uneddu; Riccardo Uggento; Lucia Farabegoli; Riccardo Ragazzi; Joseph Milic-Emili; Gian P Belloni; Raffaele Alvisi; Carlo A Volta
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-4-26
Journal Detail:
Title:  Archives of physical medicine and rehabilitation     Volume:  -     ISSN:  1532-821X     ISO Abbreviation:  -     Publication Date:  2012 Apr 
Date Detail:
Created Date:  2012-4-30     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  2985158R     Medline TA:  Arch Phys Med Rehabil     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2012 the American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.
Department of Surgical, Anaesthesiological and Radiological Sciences. Section of Anaesthesiology and Intensive Care, University of Ferrara, Italy.
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