Indicators of lung abnormalities in acute spinal cord injury

William T. Peruzzi*, M. L. Ault, M. L. Franklin, B. A. Shapiro

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

Introduction: Using chest roentgenographs (CXR) to evaluate the presence of pulmonary abnormalities is common practice. Bedside parameters such as vital capacity (VC) and negative inspiratory force (NIF) are used to assess respiratory reserves. We believe a correlation should exist between measured ventilatory parameters and CXR abnormalities. Methods: All unintubated patients admitted to the SCI intensive care unit over one year were studied. Dairy measurements of VC, forced expiratory pressure (FEP), and NIF were obtained for up to 5 days in enrolled patients. CXR's were obtained per ICU clinical protocols over the same time period and read by attending radiologists blinded to the study. The average VC, FEP, and NIF values were then compared between the two roentgenographic groups classified as either absence (CLR) or presence (POS) of atelectasis and/or infiltrate. Statistical analysis was then performed using an unpaired Student's t-test. Data from patients who demonstrated a change in their CXR from CLR to POS or POS to CLR were analyzed to determine the reliability of ventilatory parameters as a predictor of CXR changes. Results: Seventy-six patients with cervical and thoracic SCI were enrolled. A total of 123 CXR's were evaluated. There was a significant difference in mean VC, but not FEP or NIF, between the two roentgenographic groups (Table). Eight patients developed a change in their CXR (CLR to POS; POS to CLR). These patients also demonstrated a significant change in their VC measurements (mean difference of 341 mL±236, 95% C.I.) in association with the CXR changes. Conclusion: These data indicate that VC is a predictor of respiratory complications following acute SCI. Additionally, VC can be used as a clinical indicator of new or resolving roentgenographic abnormalities in individual patients. VC is dependent upon both respiratory muscle function and functional lung parenchyma and is a sensitive indicator of pulmonary abnormalities in acute SCI. x̄ POS x̄ CLR (n=35) SD (n=88) SD p-value VC 1400 ±531 1785 ±831 0.012 FEP 76 ±34 72 ±31 0.540 NIF -84 ±41 -88 ±43 0.706.

Original languageEnglish (US)
Pages (from-to)143S
JournalCHEST
Volume110
Issue number4 SUPPL.
StatePublished - Oct 1 1996

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Critical Care and Intensive Care Medicine
  • Cardiology and Cardiovascular Medicine

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