Mechanism for Respiratory Insufficiency After Cervical Cord Injury: A Source of Alveolar Hypoventilation
Publication: Annals of Internal Medicine
Volume 61, Number 3
Excerpt
Acute respiratory failure is commonly observed immediately after injury to the cervical portion of the spinal cord in man. In such patients, clinical scrutiny often demonstrates normal or enhanced excursions of the abdomen with paradoxical inspiratory retraction of the rib cage. These observations are in accord with clinical evaluation, which reveals a normally moving diaphragm and a flaccid paralysis of the muscles of the trunk and extremities. As a general rule, the acute postinjury flaccid paralysis of the muscles of the rib cage and trunk passes into a state of spastic paralysis and the paradoxical motion of the rib cage...
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References
1.
BOSHES B: Trauma to the spinal cord, in Clinical Neurology. Edited by BAKER, A. B., Harper Bros, New York, 1962.
2.
HEMINGWAY A, BORS E, and HOBBY RP: An investigation of the pulmonary function of paraplegics. J. Clin. Invest. 37: 773, 1958.
3.
STONE DJ and KELTZ H: The effect of respiratory muscle dysfunction on pulmonary function: studies in patients with spinal cord injuries. Amer. Rev. Resp. Dis. 88: 621, 1963.
4.
CUNNINGHAM DJ, GUTTMAN L, WHITTERIDGE D, and WYNDHAM CH: Cardiovascular responses to bladder distensions in paraplegic patients. J. Physiol. 121: 581, 1953.
5.
BALDWIN ED, COURNAND A, and RICHARDS DW: Pulmonary insufficiency. 1. Physiological classification, clinical methods of analysis, standard values in normal subjects. Medicine 27: 243, 1948.
6.
RILEY RL, COURNAND A, and DONALD KW: Analysis of factors affecting the concentration of oxygen and carbon dioxide in gas and blood of lungs. II. Methods. J. Appl. Physiol. 4: 102, 1951.
7.
SCHOLANDER PF: Analyzer for accurate estimation of respiratory gases in one-half cubic centimeter samples. J. Biol. Chem. 167: 235, 1947.
8.
VAN SLYKE DD and NEILL JM: The determination of gases in blood and other solutions by vacuum extraction and manometric measurement. J. Biol. Chem. 61: 523, 1924.
9.
VAN SLYKE DD and SENDROY J: Line charts for graphic calculations by Henderson-Hasselbalch equation and for calculating plasma CO2 content from whole blood content. J. Biol. Chem. 79: 781, 1928.
10.
CLARK LC, WOLF R, GRANGER D, and TAYLOR Z: Continuous recording of blood O2 tensions by polarography. J. Appl. Physiol. 6: 189, 1953.
11.
FORSTER RE, COHN JE, BRISCOE WA, BLAKEMORE WS, and RILEY RL: A modification of the Krogh carbon monoxide breath holding technic for estimating the diffusing capacity of the lung. A comparison with three other methods. J. Clin. Invest. 34: 1417, 1955.
12.
OTIS AB, FENN WO, and RAHN H: Mechanics of breathing in man. J. Appl. Physiol. 2: 592, 1950.
13.
RAHN H, OTIS AB, CHADWICK LE, and FENN WO: The pressure-volume diagram of the thorax and lung. Amer. J. Physiol. 146: 161, 1946.
14.
FRY DL, STEAD WW, EBERT RV, LUBIN RI, and WELLS HS: The measurement of intraesophageal pressure and its relationship to intrathoracic pressure. J. Lab. Clin. Med. 40: 664, 1952.
15.
BERGOFSKY EH: Relative contributions of the rib cage and diaphragm to ventilation in man. J. Appl. Physiol. 19: 561, 1964.
16.
MEAD J and WHITTENBERGER JL: Physical properties of human lungs measured during spontaneous respiration. J. Appl. Physiol. 5: 779, 1953.
17.
ALEXANDER JK, WEST JR, WOOD JA, and RICHARDS DW: Analysis of respiratory response to carbon dioxide inhalation in varying clinical states of hypercapnia, anoxia, and acid-base derangement. J. Clin. Invest. 34: 511, 1955.
18.
MCILROY MB, MARSHALL R, and CHRISTIE RV: The work of breathing in normal subjects. Clin. Sci. 13: 127, 1953.
19.
FENN WO: Mechanics of respiration. Amer. J. Med. 10: 77, 1951.
20.
BERGOFSKY EH, TURINO GM, and FISHMAN AP: Cardiorespiratory failure in kyphoscoliosis. Medicine 38: 263, 1959.
21.
FISHMAN AP, TURINO GM, and BERGOFSKY EH: The syndrome of alveolar hypoventilation. Amer. J. Med. 23: 333, 1957.
22.
RILEY RL and COURNAND AF: Pulmonary function studies in relation to chest surgery. Advances Surg. 2: 1, 1949.
23.
CAMPBELL EJ: The Respiratory Muscles and the Mechanics of Breathing, Lloyd-Luke, London, 1958, Chap. 15.
24.
CHERNIACK RM and SNIDAL DP: The effect of obstruction to breathing on the ventilatory response to CO2. J. Clin. Invest. 35: 1286, 1956.
25.
MEAD J, LINDGREN L, and GAENSLER EA: The mechanical properties of the lung in emphysema. J. Clin. Invest. 34: 1005, 1955.
26.
SIEBENS AA, KIRBY NA, and PUOLOS D: Cough following transection of spinal cord at C-6. Arch. Phys. Med. 45: 1, 1964.
Information & Authors
Information
Published In
Annals of Internal Medicine
Volume 61 • Number 3 • 1 September 1964
Pages: 435 - 447
History
Published in issue: 1 September 1964
Published online: 1 December 2008
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Mechanism for Respiratory Insufficiency After Cervical Cord Injury: A Source of Alveolar Hypoventilation. Ann Intern Med.1964;61:435-447. doi:10.7326/0003-4819-61-3-435
Mechanism for Respiratory Insufficiency After Cervical Cord Injury: A Source of Alveolar Hypoventilation. Ann Intern Med.1964;61:435-447. doi:10.7326/0003-4819-61-3-435
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