Pneumonia Following Spinal Cord Injury

• Pneumonia and Spinal Cord Injuries
• Spinal Cord Injury Respiratory Care
• Smoking and Spinal Cord Injuries

Pneumonia

Pneumonia following a spinal cord injury is a complication affecting respiratory function. This is due to decreased neuromuscular activity in the chest and abdomen. Those with tetraplegia may have decreased motor function in the diaphragm that impairs ventilation. Those with a spinal cord injury at the thoracic level of T5 and above, can have loss of intercostal muscles as well as abdominal muscles. This places paraplegics and quadriplegics at risk for developing pneumonia (lung tissue inflammation of infectious etiology) and other respiratory complications such as atelectasis (a state of airlessness within the lung) and ventilatory failure.

Over a 25 year study by The National Spinal Cord Injury Statistical Center, the causes of death that have the greatest impact on life expectancy included pneumonia, pulmonary emboli and septicemia.

Spinal Cord Injury Respiratory Care

Certain techniques can be used to minimise the effects of respiratory complications following a spinal cord injury.

These techniques include:

• Correct positioning and postural changes.
• Correct breathing techniques.
• Correct coughing techniques.
• Suctioning in higher level quadriplegics.
• Annual vaccinations for influenza.
• Cessation of smoking.

In higher level spinal cord injuries, where the requirement of tracheostomy placement and ventilatory support in acute care is needed, special attention needs to be applied to suctioning, and regular physiotherapy of the chest to keep the lungs clear.

Smoking and Spinal Cord Injuries

In patients who smoke, education and advice should be given on the consequences of smoking on the respiratory system. Smoking greatly reduces the ability to clear secretions from the lungs, and increases the risk of pneumococcal infections. The recovery rate from chest infections is also more lengthy in those with a spinal cord injury who continue to smoke.