Noninvasive mechanical ventilation in tetraplegia

Abstract

Spinal cord injury (SCI) is prevalent worldwide, with an estimated 15–40 cases per million population [1]. Injury to the cervical and upper thoracic cord may disrupt the function of the diaphragm, intercostal muscles, accessory respiratory muscles, and abdominal muscles. This causes reduction in spirometric parameters and static mouth pressures and results in ineffective cough and difficulty in clearing secretions [2]. As a result, there is a predisposition to mucus retention, atelectasis, and pulmonary infections. These respiratory complications are the most common cause of morbidity and mortality in patients with SCI, particularly in patients with cervical SCI. In acute SCI, 80 % of deaths among hospitalized patients with cervical SCI are secondary to pulmonary dysfunction, with pneumonia being the cause in 50 % of the cases [3].