Respiratory management of the spinal cord-injured patient

Spinal Cord Medicine: Second Edition

Volumn , Issue , 2011, Pages

  Shah, Akshat ^a,b   Shem, Kazuko ^a,b   Mckenna, Steve ^a,b   Berlly, Mike ^a  

^a SANTA CLARA VALLEY MEDICAL CENTER   (United States)

^b STANFORD UNIVERSITY SCHOOL OF MEDICINE   (United States)

Author keywords

[No Author keywords available]

Indexed keywords

EID: 84884825395     PISSN: None     EISSN: None     Source Type: Book    
DOI: None     Document Type: Chapter

References (136)

1. Brown R, DiMarco AF, Hoit JD, et al. Respiratory dysfunction and management in spinal cord injury. Respir Care 2006;51:853-868.
2. Garshick E, Kelley A, Cohen SA, et al. A prospective assessment of mortality in chronic spinal cord injury. Spinal Cord 2005;43:408-416.
3. DeVivo MJ, Ivie CS. Life expectancy of ventilator-dependent persons with spinal cord injuries. Chest 1995;108:226-232.
4. Devivo MJ, Krause JS, Lammertse DP. Recent trends in mortality and causes of death among persons with spinal cord injury. Arch Phys Med Rehabil 1999;80:1411-1419.
5. Shavelle RM, DeVivo MJ, Strauss DJ, et al. Long-term survival of persons ventilator dependent after spinal cord injury. J Spinal Cord Med 2006;29:511-519.
6. Consortium for Spinal Cord Medicine. Respiratory management following spinal cord injury: a clinical practice guideline for health-care professionals. J Spinal Cord Med 2005;28:259-293.
7. The Acute Respiratory Distress Syndrome Network. Ventilation with lower tidal volumes as compared with traditional tidal volumes for acute lung injury and the acute respiratory distress syndrome. N Engl J Med 2000;342:1301-1308.
8. Gosling JA. Human anatomy: color atlas and text. 3rd ed. C.V. Mosby; 1996.
9. Winslow C, Rozovsky J. Effect of spinal cord injury on the respiratory system. Am J Phys Med Rehabil 2003;82:803-814.
10. Jackson AB, Groomers TE. Incidence of respiratory complications following SCI. Arch Phys Med Rehab 1994;75:270-275.
11. Ball PA. Critical care of spinal cord injury. Spine 2001;26(24 Suppl):S27-S30.
12. Slack RSSW. Respiratory dysfunction associated with traumatic injury to the central nervous system. Clin Chest Med 1994;15:739-749.
13. Forner JV, Llombart RL, Valledor MC. The flow-volume loop in tetraplegics. Paraplegia 1977;15:245-251.
14. Estenne M, DeTroyer A. Mechanism of the postural dependence of vital capacity in tetraplegic subjects. Am Rev Respir Dis 1987;135:367-371.
15. Maloney FP. Pulmonary function in quadriplegia: effects of a corset. Arch Phys Med Rehabil 1979;60:261-265.
16. Wadsworth BM, Haines TP, Cornwell PL, et al. Abdominal binder use in people with spinal cord injuries: a systematic review and meta-analysis. Spinal Cord. 2009;47:274-285.
17. Como JJ, Sutton ER, McCunn M, et al. Characterizing the need for mechanical ventilation following cervical spinal cord injury with neurological deficit. J Trauma. 2005;59:912-916.
18. Stevens RD, Bhardwaj A, Kirsch JR, et al. Critical care and perioperative management in traumatic spinal cord injury. J Neurosurg Anesthesiol 2003;15:215-229.
19. Harrop J, Sharan A, Scheid E, et al. Tracheostomy placement in patients with complete cervical spinal cord injuries: American Spinal Injury Association Grade A. J Neurosurg 2004;100:20-23.
20. Hassid V, Schinco M, Tepas J, et al. Definitive establishment of airway control is critical for optimal outcome in lower cervical spinal cord injury. J Trauma 2008;65:1328-1332.
21. Burns SP, Rad MY, Bryant S, et al. Long-term treatment of sleep apnea in persons with spinal cord injury. Am J Phys Med Rehabil 2005;84:620-626.
22. Cotton BA, Pryor JP, Chinwilla I, et al. Respiratory complications and mortality risk associated with thoracic spine injury. J Trauma 2005;59:1400-1409.
23. Claxton R, Wong DT, Chung F, et al. Predictors of hospital mortality and mechanical ventilation in patients with cervical spinal cord injury. Can J Anesthesia 1998;45: 144-149.
24. Burns SP. Acute Respiratory Infections in Persons with Spinal Cord Injury. Phys Med Rehabil Clin N Am 2007;18:203-216.
25. Bach JR, Saporito LR. Criteria for extubation and tracheostomy tube removal for patients with ventilatory failure. A different approach to weaning. Chest 1996;110: 1566-1571.
26. Smina M, Salam A, Khamiees M, et al. Cough peak flows and extubation outcomes. Chest 2003;24:262-268.
27. Lanig IS, Peterson WP. The respiratory system in spinal cord injury. Phys Med Rehabil Clin N Am 2000;11:29-43.
28. Carter RE. Respiratory aspects of spinal cord injury management. Paraplegia 1987;25:262-266.
29. Bhaskar KR, Brown R, O'Sullivan DD, et al. Bronchial mucus hypersecretion in acute quadriplegia. Macromolecular yields and glycoconjugate composition. Am Rev Resp Dis 1991;143:640-648.
30. Lemons VR, Wagner FC Jr. Respiratory complications after cervical spinal cord injury. Spine 199419: 2315-2320.
31. Almenoff PL, Alexander LR, Spungen AM, et al. Bronchodilatory effects of iparatropium bromide in patients with tetraplegia. Paraplegia 1995;33:274-277.
32. Spungen AM, Dicpinigaitis PV, Almenoff PL, et al. Pulmonary obstruction in individuals with cervical spinal cord lesions unmasked by bronchodilator administration. Paraplegia 1993;31(6):404-407.
33. Spungen AM, Grimm DR, Stakhan M, et al. Treatment with anabolic agent is associated with improvement in respiratory function in persons with tetraplegia: a pilot study. Mt Sanai J Med 1999;66(3):201-205.
34. Gonzalez EG, Edelstein JE, et al. Physiological basis of rehabilitation medicine. Woburn, MA: Butterworth-Heinmemann; 2001.
35. Chen D Apple DF, Hudson LM, et al. Medical complications during acute rehabilitation following spinal cord injury current experience of the model systems. Arch Phys Med Rehabil 1999;80:1397-1401.
36. American Thoracic Society; Infectious Diseases Society of America. Guidelines for the management of adults with hospital-acquired, ventilator-associated, and healthcare-associated pneumonia. Am J Respir Crit Care Med2005;171(4):388-416.
37. Bartlett J, Gorbach SL, Finegold S. The bacteriology of aspiration pneumonia. Am J Med 1974;56:202-207.
38. Bartlett J, Gorbach SL, Tally F, et al. Bacteriology and treatment of primary lung abscess. Am Rev Respir Dis 1974;109:510-519.
39. Kirshblum S, Johnston MV, Brown J, et al. Predictors of dysphagia after spinal cord injury. Arch Phys Med Rehab 1999;80(9):1101-1105.
40. DeVita MA, Spierer-Rundback L. Swallowing disorders in patients with prolonged orotracheal intubation or tracheostomy tubes. Crit Care Med 1990;18(12): 1328-1330.
41. Elpern EH, Scott MG, Petro L, et al. Pulmonary aspiration in mechanically ventilated patients with tracheostomies. Chest 1994;105(2):563-566.
42. Berlly M, Shem K. Respiratory management during the first five days after spinal cord injury. J Spinal Cord Med 2007;30:309-318
43. Lanes SF, Garcia Rodriguez LA, Huerta C. Respiratory medications and risk of asthma death. Thorax 2002;57(8):683-686.
44. Salpeter SR, Ormiston TM, Salpeter EE. Meta-analysis: respiratory tolerance to regular beta2-agonist use in patients with asthma. Ann Intern Med 2004;140(10): 802-813.
45. Spitzer WO, Suissa S, Ernst P, et al. The use of beta-agonists and the risk of death and near death from asthma. N Engl J Med 1992;326:501-506.
46. Salpeter SR, Buckley NS, Ormiston TM, et al. Meta-analysis: effect of long-acting beta-agonists on severe asthma exacerbations and asthma-related deaths. Ann Intern Med 2006;144:904-912.
47. Schilero GJ, Grimm D, Spungen AM, et al. Bronchodilator responses to metaproterenol sulfate among subjects with spinal cord injury. J Rehabil Res Dev 2004;41:59-64.
48. Grimm DR, Schilero GJ, Spungen AM, et al. Salmeterol improves pulmonary function in persons with tetraplegia. Lung 2006;184:335-339.
49. Gross N. Anticholinergic agents in asthma and COPD. Eur J Pharmocol 2006;533:36-39.
50. Summers QA, Tarala RA. Nebulized ipratropium in the treatment of acute asthma. Chest 1990;97:425-429.
51. Teale C, Morrison JF, Muers MF, et al. Response to nebulized ipratropium bromide and terbutaline in acute severe asthma. Resp Med 1992;86:215-218.
52. Westby M, Benson M, Gibson P. Anticholinergic agents for chronic asthma in adults. Cochrane Database Syst Rev 2004(3):CD003269.
53. Matsumoto T, Tamaki T, Kawakami M, et al. Early complications of high-dose methylprednisolone sodium succinate treatment in the follow-up of acute cervical spinal cord injury. Spine 2001;26:426-430.
54. Foxworth JW, Reisz GR, Knudson SM, et al. Theophylline and diaphragmatic contractility. Investigation of a dose-response relationship. Am Rev Respir Dis 1988;138:1532-1534.
55. Murciano D, Aubier M, Lecocguic Y, et al. Effects of theophylline on diaphragmatic strength and fatigue in patients with chronic obstructive pulmonary disease. N Engl J Med 1984;311:349-353.
56. McBride DQ, Rodts GE. Intensive care of patients with spinal trauma. Neurosurg Int Care 1994;5:755-766.
57. Sortor S. Pulmonary issues in quadriplegia. Eur Respir Rev 1992;2:330-334.
58. Waters RJ, Meyers PR, Adkins R, et al. Emergency, acute, and surgical management of spine trauma. Arch Phys Med Rehabil 1999;80:1383-1390.
59. Powell M, Kirshblum S, O'Connor KC. Duplex ultrasound screening for deep vein thrombosis in spinal cord injured patients at rehabilitation admission. Arch Phys Med Rehabil 1999;80:1044-1046.
60. Wallbom AS, Thomas E. Acute ventilator management and weaning in individuals with high tetraplegia. St. Louis, MO: Thomas Land Publishers Birmingham, AL, Inc.; 2005.
61. Peterson WP, Barbalata L, Brooks CA, et al. The effect of tidal volumes on the time to wean persons with hightet aplegia from ventilators. Spinal Cord 1999;37: 284-288.
62. McMichan JC, Michel L, Westbrook PR. Pulmonary dysfunction following traumatic quadriplegia. Recognition, prevention, and treatment. JAMA 1980;243(6):528-531.
63. Cook N. Respiratory care in spinal cord injury with associated traumatic brain injury: bridging the gap in critical care nursing intervention. Int Crit Care Nurs 2003;19:143-153.
64. Kinney TB, Rose SC, Valji K, et al. Does Cervical spinal cord injury induce a higher incidence of complications after prophylactic Greenfield filter usage? J Vasc Interv Radiol 1996;7:907-915.
65. Gomez-Merino E, Sancho J, Marin J. Mechanical insufflation-exsufflation: pressure, volume, and flow relationships and the adequacy of the manufacturer's guidelines. Am J Phys Med Rehabil 2002;81:579-583.
66. Garstang SV, Kirshblum S, Wood KE. Patient preference for in-exsufflation for secretion management in spinal cord injury. J Spinal Cord Med 2000;23:80-85.
67. Fishburn MJ, Marino RJ, Ditunno JF. Atelectasis and pneumonia in acute spinal cord injury. Arch Phys Med Rehabil 1990;71:197-200.
68. Winslow C, Bode R, Felton D, et al. Impact of respiratory complications on length of stay and hospital costs in acute cervical spine injury. Chest 2002;121:1548-1554.
69. Peterson P, Kirshblum SC. Respiratory management in spinal cord injury. In: Kirshblum SC, Campagnolo D, DeLisa JE, eds. Spinal cord medicine. Philadelphia, PA: Lippincott/Williams & Wilkins; 2002:135-154.
70. Lin KH, Chuang CC, Wu HD, et al. Abdominal weight and inspiratory resistance: their immediate effects on inspiratory muscle functions during maximal voluntary breathing in chronic tetraplegic patients. Arch Phys Med Rehabil1999;80:741-745.
71. Van Houtte S, Vanlandewijck Y, Gosselink R. Respiratory muscle training in persons with spinal cord injury: a systematic review. Resp Med 2006;100:1886-1895.
72. Delardo AF, Onders RP, Ignagni A, et al. Diaphragm electrodes in tetraplegic phrenic nerve pacing via intramuscular subjects. Chest 2005;127:671-678.
73. Checkley W, Brower R, Korpak A, et al. Effects of a clinical trial on mechanical ventilation practices in patients with acute lung injury. Am J Resp Crit Care Med 2008;177:1215-1222.
74. Gross D, Ladd HW, Riley EJ, et al. The effect of training on strength and endurance of the diaphragm in quadriplegia. Am J Med 1980;68:27-35.
75. Leith D, Bradley M. Ventilatory muscle strength and endurance training. J Appl Physiol 1976;41:508-516.
76. Liaw MY, Lin MC, Cheng P. Resistive inspiratory muscle training: its effectiveness in patients with acute complete cervical cord injury. Arch Phys Med Rehabil 2000;81:752-756.
77. McKinley W. Late return of diaphragm function in a ventilator-dependent patient with a high cervical tetraplegia: case report, and interactive review. Spinal Cord 1996;34:626-629.
78. Oo T, Watt JW, Soni BM, et al. Delayed diaphragm recovery in 12 patients after high cervical spinal cord injury. A retrospective review of the diaphragm status of 107 patients ventilated after acute spinal cord injury. Spinal Cord1999;37:117-122.
79. Peterson W, Charlifue W, Gerhart A, et al. Two methods of weaning persons with quadriplegia from mechanical ventilators. Paraplegia 1994;32:98-103.
80. Report H. Misuse of fenestrated tracheostomy tubes [Hazard Report]. Health devices. 1978 Jan;7(3):91
81. Wicks AB, Menter RR. Long-term outlook in quadriplegic patients with initial ventilator dependency. Chest 1986;90:406-410.
82. Chiodo AE, Scelza W, Forchheimer M. Predictors of ventilatory weaning in individuals with high cervical spinal cord inury. J Spinal Cord Med. 2008;31:72-77.
83. Gardner BP, Watt JW, Krishnan KR. The artificial ventilation of acute spinal cord damaged patients: a retrospective study of forty-four patients. Paraplegia 1986;24:208-220.
84. Bach JR, Alba AS. Noninvasive options for ventilatory support of the traumatic high level quadriplegia patient. Chest 1990;98:613-619.
85. DiMarco AF, Onders RP, Ignagni A, et al. Phrenic nerve pacing via intramuscular diaphragm electrodes in tetraplegic subjects. Chest 2005;127:671-678.
86. DiMarco AF, Onders RP, Ignagni A, et al. Inspiratory muscle pacing in spinal cord injury: case report and clinical commentary. J Spinal Cord Med 2006;29:95-108.
87. Shaul DB, Danielson PD, McComb JG, et al. Thoracoscopic placement of phrenic nerve electrodes for diaphragmatic pacing in children. J Pediatr Surg 2002;37(7):974-978.
88. Strakowski JA, Pease W, Johnson EW. Phrenic nerve stimulation in the evaluation of ventilator-dependent individuals with C4- and C5- level spinal cord injury. Am J Phys Med Rehabil 2007;86:153-157.
89. Lieberman JS, Corgil G, Nayak NN, et al. Serial phrenic nerve conduction studies in candidates for diaphragm pacing. Arch Phys Med Rehabil 1980;61:528-531.
90. Hall AM, Watt JW. The use of tracheal stoma stents in high spinal cord injury: a patient-friendly alternative to long-term tracheostomy tubes. Spinal Cord 2008. Nov;46(11):753-755.
91. Krieger LM, Krieger AJ. The intercostal to phrenic nerve transfer: an effective means of reanimating the diaphragm in patients with high cervical spine injury. Plastic Recon Surg 2000;105:1255-1261.
92. Onders RP, Elmo M, Khansarinia S, et al. Complete worldwide operative experience in laparoscopic diaphragm pacing: results and differences in spinal cord injured patients and amyotrophic lateral sclerosis patients. Surg Endosc2009;23:1433-1440. Epub 2008 Dec 6.
93. Onders RP, Elmo MJ, Ignagni AR. Diaphragm pacing stimulation system for tetraplegia in individuals injured during childhood or adolescence. J Spinal Cord Med 2007;30(Suppl 1):S25-S29.
94. Alshekhlee A, Onders RP, Syed TU, et al. Phrenic nerve conduction studies in spinal cord injury: applications for diaphragmatic pacing. Muscle Nerve 2008;38:1546-1552.
95. Jain NB, Brown R, Tun CG, et al. Determinants of forced expiratory volume in 1 second (FEV1), forced vital capacity (FVC), and FEV1/FVC in chronic spinal cord injury. Arch Phys Med Rehabil 2006;87:1327-1333.
96. Devivo MJ. Epidemiology of traumatic spinal cord injury. In: Kirshblum SC, Campagnolo D, DeLisa JL, eds. Spinal cord medicine. Philadelphia: Lippincott/Williams & Wilkins; 2002:69-81
97. Devivo MJ, Stover SL. Long-term survival and causes of death. In: Stover SL, DeLisa JL, Whiteneck GG, eds. Spinal cord injury: clinical outcomes from the model systems. Gaithersburg, MD: Aspen Publishers; 1995:289-316.
98. Cardenas DD, Hoffman JM, Kirshblum S, et al. Etiology and incidence of rehospitalization after traumatic spinal cord injury: a multicenter analysis. Arch Phys Med Rehabil 2004;85:1757-1763.
99. Sipski ML, Richards JS. Spinal cord injury rehabilitation: state of the science. Am J Phys Med Rehabil 2006;85:210-342
100. Ragnarsson KT, Hall KM, Wilmot CB, et al. Management of pulmonary, cardiovascular and metabolic conditions after spinal cord injury. In: Stover SL, DeLisa JL, Whiteneck GG, eds. Spinal cord injury: clinical outcomes for the model systems. Gaithersberg, MD: Aspen Publishers; 1995:79-99.82.
101. McCrory DC, Samsa GP, Hamilton BP, et al. Treatment of pulmonary disease following spinal cord injury. Evid Rep Technol Assess (Summ). 2001 Jun;(27):1-4.
102. McKinley WO, Jackson AB, Cardenas DD, et al. Long-term medical complications after traumatic spinal cord injury: a regional model systems analysis. Arch Phys Med Rehabil 1999;80:1402-1410.
103. Meyers AB, Bisbee A, Winter M. The "Boston Model" of managed care spinal cord injury: a cross-sectional study of the outcomes of risk-based, pre-paid, managed care. Arch Phys Med Rehabil 1999;80:1450-1456.
104. Burns SP, Weaver FM, Parada JP, et al. Management of community-acquired pneumonia in persons with spinal cord injury. Spinal Cord 2004;42:450-458.
105. Smith BM, Evans CT, Kurichi JE, et al. Acute respiratory tract infection visits of veterans with spinal cord injuries and disorders: rates, trends, and risk factors. J Spinal Cord Med 2007;30:355-361.
106. Weaver FM, Smith B, Evans CT, et al. Outcomes of outpatient visits for acute respiratory illness in veterans with spinal cord injuries and disorders. Am J Phys Med Rehabil 2006;85:718-726.
107. Chang H, Evans C, Weaver F, et al. Etiology and outcomes of veterans with spinal cord injury and disorders hospitalized and community acquired pneumonia. Arch Phys Med Rehabil 2005;86(2):262-267.
108. Bach JR. Inappropriate weaning and late onset ventilatory failure of individuals with traumatic spinal cord injury. Paraplegia 1993;31:430-438.
109. Bach JR, Rajaraman R, Ballanger F, et al. Neuromuscular ventilatory insufficiency: effect of home mechanical ventilator use v oxygen therapy on pneumonia and hospitalization rates. Am J Phys Med Rehabil 1998;77:8-19.
110. Kirby NA, Barnerias MJ, Siebens AA. An evaluation of assisted cough in quadriparetic patients. Arch Phys Med Rehabil 1966;47:705-710.
111. Jaegar RJ, et al. Cough in spinal cord injured patients: comparison of three methods to produce cough. Arch Phys Med Rehabil 1993;74:1358-1361.
112. Leiner GC. Cough peak flow rate. Am J Med Sci 1966;22:121-124.
113. Gomez-Merino E, Bach JR. Duchenne muscular dystrophy: prolongation of life by noninvasive ventilation and mechanically assisted coughing. Am J Phys Med Rehabil 2002;81:411-415.
114. Grandas NF, Jain NB, Denckla JB, et al. Dyspnea during daily activities in chronic spinal cord injury. Arch Phys Med Rehabil 2005;86:1631-1635.
115. Toki A, Tamura R, Sumida M. Long-term ventilation for high-level tetraplegia: a report of 2 cases of noninvasive positive pressure ventilation. Arch Phys Med Rehabil 2008;89:779-783.
116. Eltorai IM, Segal J. Emergencies in chronic spinal cord injury patients. 3rd ed. New York, NY: Eastern Paralyzed Veterans Association; 2001
117. Trautner BW, Atmar RL, Hulstrom A, et al. Inactivated influenza vaccination for people with spinal cord injury. Arch Phys Med Rehabil 2004;85:1886-1889.
118. Evans CT, Legro MW, Weaver FM, et al. Influenza vaccination among veterans with spinal cord injury: Part 1. A survey of attitudes and behavior. J Spinal Cord Med 2003;26:204-209.
119. Weaver FM, Goldstein B, Evans CT, et al. Influenza vaccination among veterans with spinal cord injury: Part 2. Increasing vaccination rates. J Spinal Cord Med 2003;26:210-218.
120. Weaver FM, Smith B, LaVela S, et al. Interventions to increase influenza vaccination rates in veterans with spinal cord injuries and disorders. J Spinal Cord Med 2007;30:10-19.
121. Evans CT, Lavel SL, Smith B, et al. Influenza diagnosis and treatment in veterans with spinal cord injury. Arch Phys Med Rehabil 2006;87:291-293.
122. Report from the Advisory Committee on Immunization Practices (ACIP): Decision Not to Recommend Routine Vaccination of All Children Aged 2-10 Years with Quadrivalent Meningococcal Conjugate Vaccine (MCV4). MMWR Morbid Mortal Wkly Rep. 2008;57(17)462-465.
123. Waites KB, Canupp KC, Chen YY, et al. Revaccination of adults with spinal cord injury using the 23-valent pneumococcal polysaccharide vaccine. J Spinal Cord Med 2008;31:53-59.
124. Berlowitz DJ, Brown DJ, Campbell DA, et al. A longitudinal evaluation of sleep and breathing in the first year after cervical spinal cord injury. Arch Phys Med Rehabil 2005;86:1193-1199.
125. Burns SP, Little JW, Hussey JD, et al. Sleep apnea syndrome in chronic spinal cord injury: associated factors and treatment. Arch Phys Med Rehabil 2000;81: 1334-1339.
126. Flavell H, Marshall R, Thornton AT, et al. Hypoxia episodes during sleep in high tetraplegia. Arch Phys Med Rehabil 1992;73:623-627.
127. Klefbeck B, Sternhag M, Weinberg J, et al. Obstructive sleep apneas in relation to severity of cervical spinal cord injury. Spinal Cord 1998;36:621-628.
128. Leduc BE, Dagher JH, Mayer P, et al. Estimated prevalence of obstructive sleep apnea-hypopnea syndrome after cervical cord injury. Arch Phys Med Rehabil 2007;88:333-337.
129. Short DJ, Stradling JR, Williams SJ. Prevalence of sleep apnoea in patients over 40 years of age with spinal cord lesions. J Neurol Neurosurg Psych 1992;55:1032-1036.
130. Burns SP, Kapur V, Yin KS, et al. Factors associated with sleep apnea in men with spinal cord injury: a population-based case-control study. Spinal Cord 2001;39:15-22.
131. Stockhammer E, Tobon A, Michel F, et al. Characteristics of sleep apnea syndrome in tetraplegic patients. Spinal Cord 2002;40:286-294.
132. Ayas NT, Epstein LJ, Lieberman SL, et al. Predictors of loud snoring in persons with spinal cord injury. J Spinal Cord Med 2001;24:30-34.
133. Bonekat HW, Anderson G, Squires J. Obstructive disordered breathing during sleep in patients with spinal cord injury. Paraplegia 1990;28:392-398.
134. Biering-Sorensen M, Norup PW, Jacobsen E, et al. Treatment of sleep apnoea in spinal cord injured patients. Paraplegia 1995;33:271-273.
135. Wang TG, Wang YH, Tang FT, et al. Resistive inspiratory muscle training in sleep-disordered breathing of traumatic tetraplegia. Arch Phys Med Rehabil 2002;83: 491-496.
136. Bach JR. Chronic alveolar hypoventilation as a late complication of spinal cord injury. J Spinal Cord Med 1995;18:255.