2019 Fall/Winter Connections Spring 2020 | Page 8

Good Respiratory Hygiene after Spinal Cord Injury

James Wilson, DO

Spinal Cord Injury Director

MetroHealth Rehabilitation Institute of Ohio

Spinal cord injury (SCI) is damage to the thick bundle of nerves that travel down your neck and back. It sends and receives messages between the brain and the body. These messages can mostly be divided into 2 systems: the somatic nervous system and the autonomic nervous system. Somatic nerves serve most of the obvious jobs like muscles and sensation. Autonomic nerves work mostly behind the scenes to manage things like your blood pressure, body temperature, or sweating.

After SCI, your respiratory system could be affected a little or a lot. The first thing we ask is where in your back or neck was the SCI, since the higher your injury, the more likely you are to have trouble with breathing. This could be changes in somatic nerves (taking a deep breath or coughing up mucus) and/or autonomic nerves (thicker mucus or tighter, skinnier airways). These and other changes can lead to various problems:

Pneumonia (infections)

Aspiration (food or secretions accidentally getting in the lungs)

Atelectasis (areas of the lung that don’t inflate)

Asthma (tight airways)

Ventilatory failure (need for a machine to help you to breath)

Mucus plugging (airways blocked with thick secretions)

Effusion (fluid collecting around the lung)

Tracheostomy (a tube placed in the front of your neck)