J Korean Acad Rehabil Med.  2004 Oct;28(5):501-504.

Non-invasive Intermittent Positive Pressure Ventilation Apply to Complete Tetraplegia due to C1 Spinal Cord Injury: A case report

• Park JH
• Kang SW
• Cho DH

Abstract

The patients who have high cervical cord injury with paralysis of diaphragm are not able to live without mechanical ventilatory support. In conventional concept, tracheostomy is necessary for long-term use of mechanical ventilation. We reported a 33-year-old man diagnosed with complete tetraplegia due to C1 spinal cord injury. He had used intermittent mechanical ventilation via tracheostomy tube. He had no movement of diaphragm and showed hypercapnia and hypoxemia without ventilatory support for several hours. He showed 400 ml of vital capacity and un-obtainable peak cough flow level but it could be obtained 300 L/min of assisted peak cough flow. Noninvasive intermittent positive pressure ventilation (NIPPV) was applied from invasive method and decannulation and tracheostomy closure was performed successfully. He had no pulmonary complications for six months. This case could be a good model for the indication of NIPPV application and decannulation.

Keyword

Tetraplegia; Tracheostomy; Decannulation; Pulmonary rehabilitation; Noninvasive intermittent positive pressure ventilation

MeSH Terms

Adult
Anoxia
Cough
Diaphragm
Humans
Hypercapnia
Intermittent Positive-Pressure Ventilation*
Paralysis
Quadriplegia*
Respiration, Artificial
Spinal Cord Injuries*
Spinal Cord*
Tracheostomy
Vital Capacity