Pulmonary rehabilitation throughout the weaning from mechanical ventilation for complete cervical spinal cord injury: A case report

Abstract

The aim of this report was to present a tailored program of weaning from mechanical ventilation successfully. This program was developed for the ventilator-dependent patient with spinal cord injury (SCI) and especially targeting the respiratory muscles. A 48-year old male had a car accident on 25 May 2019 and his limb muscle strengths were severely impaired. He was diagnosed with complete cervical spinal cord injury (level C4), difficult-to-wean. Electrical impedance tomography was used to direct the rehabilitation program. Besides, passive activities (stretching of the intercostal muscles, bed tilting, and passive movement of the scapula and the proximal end of the upper limbs) and active training (various diaphragmatic facilitation techniques) were applied for inspiratory muscle training. The patient was successfully weaned from mechanical ventilation and discharged from the hospital. The individualization of rehabilitation program was demonstrated before, during, and after weaning for the SCI patient. Rehabilitation program especially targeting the respiratory muscles would facilitate the weaning process for complete spinal cord injury.