How does pneumonia occur in patients with spinal cord injuries?
im doing this case study for school and i'm having a difficult time figuring out how exactly a patient can have pneumonia or even acute respiratory failure due to spinal cord injury.
Answers:
Respiratory complications and infection predominate as post-spinal cord injury complications. When the injury involves the upper thorax, the normal breathing pattern is permanently altered. The diaphragm does most of the work in quiet breathing. The chest wall muscles (intercostals) are used primarily for deep breathing or coughing. The abdominal muscles also participate in coughing. When the intercostal and abdominal muscles are paralyzed, the entire load is taken by the diaphragm. This results in poor coughing and a high risk of pneumonia. Pneumonia is one of the most common complications of acute spinal cord injury. Preventive measures are very important to reduce the risk of pneumonia. These include: percussion and drainage using gravity to assist; assisted coughing (also termed "quad" coughing); abdominal binders (to increase the resistance against which the diaphragm works); and early mobilization (i.e.; getting the patient out of bed as soon as possible)
They aren't mobile.
Any time one is injured they are more suseptible to infection. Pneumonia is the most common. Their immune systems are down.
Because their lungs are no longer getting the same amount of use, they no longer run or play basketball or swim...the diaphragm, which is the flat muscle that moves the lungs, can atrophy and muscle waste very easily. The constant state of normal, shallow breath and the immobilization can lead to respiratory infections, which will lead to pneumonia, which can lead to ARDS and respiratory failure. Unfortunately, most people who are immobile die because of resp. disease and not the injury that keeps them immobile.
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Answers:
Respiratory complications and infection predominate as post-spinal cord injury complications. When the injury involves the upper thorax, the normal breathing pattern is permanently altered. The diaphragm does most of the work in quiet breathing. The chest wall muscles (intercostals) are used primarily for deep breathing or coughing. The abdominal muscles also participate in coughing. When the intercostal and abdominal muscles are paralyzed, the entire load is taken by the diaphragm. This results in poor coughing and a high risk of pneumonia. Pneumonia is one of the most common complications of acute spinal cord injury. Preventive measures are very important to reduce the risk of pneumonia. These include: percussion and drainage using gravity to assist; assisted coughing (also termed "quad" coughing); abdominal binders (to increase the resistance against which the diaphragm works); and early mobilization (i.e.; getting the patient out of bed as soon as possible)
They aren't mobile.
Any time one is injured they are more suseptible to infection. Pneumonia is the most common. Their immune systems are down.
Because their lungs are no longer getting the same amount of use, they no longer run or play basketball or swim...the diaphragm, which is the flat muscle that moves the lungs, can atrophy and muscle waste very easily. The constant state of normal, shallow breath and the immobilization can lead to respiratory infections, which will lead to pneumonia, which can lead to ARDS and respiratory failure. Unfortunately, most people who are immobile die because of resp. disease and not the injury that keeps them immobile.
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