Respiratory dysfunction associated with traumatic injury to the central nervous system

Area of Science:

• Neurology
• Pulmonology
• Rehabilitation Medicine

Background:

• Head trauma and spinal cord injury frequently lead to pulmonary dysfunction.
• Abnormal breathing patterns indicate altered neural integration affecting respiratory control.
• Early hypoxemia can arise from various complications like V/Q mismatching and ARDS.

Purpose of the Study:

• To review the impact of central nervous system (CNS) injuries on pulmonary function.
• To highlight the importance of pulmonary hygiene and respiratory muscle training for patient survival.
• To discuss mechanical ventilation strategies and emerging assistive devices.

Main Methods:

• Review of literature concerning pulmonary complications in CNS injuries.
• Analysis of respiratory muscle function and its recovery.
• Evaluation of pulmonary hygiene protocols and mechanical ventilation outcomes.

Main Results:

• Spinal cord injury can cause significant changes in lung volumes and gas exchange due to muscle dysfunction.
• Accessory respiratory muscles are crucial for stabilizing the rib cage and improving expiratory function.
• Strength training enhances expiratory muscle function in quadriplegics.

Conclusions:

• Vigorous pulmonary hygiene is critical for improving survival in patients with CNS injuries.
• A comprehensive pulmonary hygiene program includes positioning, assisted coughing, breathing exercises, and monitoring.
• Successful weaning from mechanical ventilation is correlated with long-term survival; consider non-tracheostomy assist devices.