Pulmonary Complications

Question 1

What SCI patient population experiences more pulmonary complications

Answer 1

High cervical injuries

Question 2

What is required for SCI to have diaphragmatic pacing

Answer 2

An intact phrenic nerve nucleus

Question 3

Mechanical ventilation should be started when you have a PO2 or PCO2 of how much?

Answer 3

PO2 < 50

PCO2 > 50

Question 4

What kind of test is needed to determine if phrenic nerve is affected

Answer 4

EMG of diaphragm or NCS or phrenic nerve

Question 5

Most frequent pulmonary complications in SCI patients

Answer 5

Pneumonia, atelectasis, ventilatory failure

Question 6

What can be done to cervical SCI patients to improve vital capacity?

Answer 6

Use of an abdominal binder in the sitting position

Question 7

In SCI vs NMD patient, is VC better to supine or sitting?

Answer 7

SCI = better in supine
NMD = better sitting

Question 8

All lung volumes decrease as a result of SCI except which one?

Answer 8

Residual volume

Question 9

What is the highest level of SCI at which spontaneous ventilation can be sustained

Answer 9

C4

Question 10

When vital capacity reaches __________, mechanical ventilation should be considered

Answer 10

<1L

Question 11

3 main causes of failure of phrenic nerve pacing

Answer 11

1. Infection
2. Obstruction
3. Medications

Question 12

For phrenic nerve NCS, where do you put the active and reference electrodes, and where do you stimulate?

Answer 12

G1 = 2cm below xiphoid process
G2 = 16cm distal from G1 along anterior costal margin
Stimulation = lateral neck posterior to SCM

Question 13

1 cause of death within 1 year of SCI

Answer 13

Pneumonia

Question 14

How much do you start tidal volume at when ventilating patients

Answer 14

15mL/kg