A Primary Care Provider’s Guide to Managing Respiratory Health in Subacute and Chronic Spinal Cord Injury

Top Spinal Cord Inj Rehabil, 2020 · DOI: 10.46292/sci2602-116 · Published: April 1, 2020

Spinal Cord Injury Pulmonology Healthcare

Simple Explanation

Respiratory complications are a leading cause of death and hospitalization after spinal cord injury (SCI). These complications include atelectasis, pneumonia, blood clots, and sleep-disordered breathing. The risk is higher with more severe SCI. Optimal care involves monitoring for respiratory issues, preventative measures like vaccinations and respiratory muscle training, and early treatment of pneumonia with secretion management. Primary care providers, along with the patient, rehabilitation specialists, and pulmonologists, are key to optimizing respiratory health after SCI.

Study Duration

Not specified

Participants

Not specified

Evidence Level

Not specified

Key Findings

1
Respiratory diseases, especially pneumonia, are a leading cause of death after SCI and a frequent reason for rehospitalization.
2
Higher levels and completeness of SCI correlate with greater ventilatory dysfunction and increased risk of respiratory complications.
3
Sleep-disordered breathing is highly prevalent in individuals with SCI, especially those with tetraplegia and complete injuries.

Research Summary

Respiratory complications are a major cause of death and rehospitalization following SCI, with pneumonia being particularly dangerous. Vigilant prevention, early detection, and aggressive treatment are crucial. Primary care providers play a critical role in the ongoing management of respiratory health in individuals with SCI, including preventive measures, surveillance, and specialized treatment. More research is needed to fully understand the benefits of respiratory interventions and the combined effects of aging and SCI on respiratory health.

Practical Implications

Vaccination

Ensure up-to-date influenza vaccinations and consider pneumococcal vaccination.

Respiratory Muscle Training

Encourage regular use of respiratory muscle training exercises and cough effectiveness strategies.

Sleep Apnea Monitoring

Perform surveillance for signs or symptoms of sleep-disordered breathing.

Study Limitations

1
The article was written before the COVID-19 pandemic, lacking specific information on COVID-19 management in SCI patients.
2
More research is needed to define the functional benefits of many respiratory interventions used in SCI.
3
Longitudinal studies are needed to improve understanding of the combined impact of aging and SCI on respiratory health.

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