Respiratory complications are a leading cause of death post injury
All patients with a spinal cord injury above L1 will have some form of lung dysfunction. The higher the level of injury the more severe the lung dysfunction will be
As vital capacity is directly related to respiratory muscle strength, the higher the spinal cord injury the greater the decrease in vital capacity. A downward trend in vital capacity should be fully investigated as may lead to respiratory insufficiency
Patients with tetraplegia with lesions at C5 and above have improved ventilation in supine position. Vital capacity is decreased in the sitting position due to increased effects of gravity on the abdominal contents, which leads to increased residual lung volume
Atelectasis is the most common respiratory complication in patients with spinal cord injury and may lead to pneumonia, pleural effusion, and empyema
Respiratory infections should be treated promptly with assisted coughing, physiotherapy, and antibiotics
Patients with tetraplegia should be encouraged to perform daily routine inspiratory resistive training as this has been shown to improve strength and endurance of weak diaphragms and increase lung function