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High-level quadriplegics perceive lung volume change.

R B Banzett, R W Lansing, R Brown

    Journal of Applied Physiology (Bethesda, Md. : 1985)
    |February 1, 1987
    PubMed
    Summary
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    High-level quadriplegic patients can detect small changes in ventilator tidal volume. This sensory ability, originating within the chest, is comparable to that of unimpaired individuals.

    Area of Science:

    • Respiratory Physiology
    • Neuroscience
    • Rehabilitation Medicine

    Background:

    • Tracheostomized individuals with high-level quadriplegia often rely on mechanical ventilation.
    • Assessing sensory feedback in this population is crucial for understanding respiratory control and patient comfort.

    Purpose of the Study:

    • To investigate the capacity of tracheostomized, high-level quadriplegic patients to perceive alterations in ventilator-delivered tidal volume.
    • To compare this sensory discrimination ability with that of healthy individuals.

    Main Methods:

    • A forced-choice procedure was employed to assess tidal volume change detection.
    • Subjects indicated whether a single breath was larger or smaller than control breaths.
    • The study involved quadriplegic patients with limited somatic sensation and a control group of normal subjects.

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    Main Results:

    • Quadriplegic patients demonstrated the ability to detect tidal volume changes as small as 100 ml.
    • Their detection performance was comparable to that of the normal subject group.
    • Patients reported the sensation for volume discrimination originated within the chest, despite lack of somatic sensation below the neck.

    Conclusions:

    • High-level quadriplegic patients possess a significant ability to detect changes in mechanical ventilator tidal volume.
    • This sensory feedback mechanism appears to be intrinsic to the chest, independent of somatic sensation.
    • Findings suggest preserved visceral afferent pathways involved in respiratory load detection.