scholarly journals Speaking Tracheostomy Tube and Modified Mouthstick Stylus in a Ventilator-Dependent Patient with Spinal Cord Injury

2015 ◽  
Vol 2015 ◽  
pp. 1-3 ◽  
Author(s):  
Eiji Mitate ◽  
Kensuke Kubota ◽  
Kenji Ueki ◽  
Rumi Inoue ◽  
Ryosuke Inoue ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Tracheostomy Tube ◽  
Cervical Spinal Cord ◽  
Cardiopulmonary Arrest ◽  
Respiratory Muscles ◽  
Successful Resuscitation ◽  
Cord Injury ◽  
Suction Line ◽  
Dependent Patient

Communication is a serious problem for patients with ventilator-dependent tetraplegia. A 73-year-old man was presented at the emergency room in cardiopulmonary arrest after falling from a height of 2 m. After successful resuscitation, fractures of the cervical spine and cervical spinal cord injury were found. Due to paralysis of the respiratory muscles, a mechanical ventilator with a tracheostomy tube was required. First, a cuffed tracheostomy tube and a speaking tracheostomy tube were inserted, and humidified oxygen was introduced via the suction line. Using these tubes, the patient could produce speech sounds, but use was limited to 10 min due to discomfort. Second, a mouthstick stylus, fixed on a mouthpiece that fits over the maxillary teeth, was used. The patient used both a communication board and a touch screen device with this mouthstick stylus. The speaking tracheostomy tube and mouthstick stylus greatly improved his ability to communicate.

scholarly journals Pulmonary Rehabilitation throughout the Weaning from Mechanical Ventilation for Complete Cervical Spinal Cord Injury: A Case Report

2020 ◽  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Mechanical Ventilation ◽  
Cervical Spinal Cord ◽  
Respiratory Muscles ◽  
Rehabilitation Program ◽  
Cervical Spinal Cord Injury ◽  
Weaning From Mechanical Ventilation ◽  
Impedance Tomography ◽  
Cord Injury

The aim of this report was to present a tailored program of weaning from mechanical ventilation successfully. This program was developed for the ventilator-dependent patient with spinal cord injury (SCI) and especially targeting the respiratory muscles. A 48-year old male had a car accident on 25 May 2019 and his limb muscle strengths were severely impaired. He was diagnosed with complete cervical spinal cord injury (level C4), difficult-to-wean. Electrical impedance tomography was used to direct the rehabilitation program. Besides, passive activities (stretching of the intercostal muscles, bed tilting, and passive movement of the scapula and the proximal end of the upper limbs) and active training (various diaphragmatic facilitation techniques) were applied for inspiratory muscle training. The patient was successfully weaned from mechanical ventilation and discharged from the hospital. The individualization of rehabilitation program was demonstrated before, during, and after weaning for the SCI patient. Rehabilitation program especially targeting the respiratory muscles would facilitate the weaning process for complete spinal cord injury.

Invited Review: The crossed phrenic phenomenon: a model for plasticity in the respiratory pathways following spinal cord injury

2003 ◽  
Vol 94 (2) ◽  
pp. 795-810 ◽  
Author(s):  
Harry G. Goshgarian
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Cervical Spinal Cord ◽  
Mammalian Species ◽  
Respiratory Muscles ◽  
Respiratory Drive ◽  
Respiratory Pathway ◽  
Physiological Basis ◽  
Cord Injury ◽  
Crossed Phrenic Phenomenon

Hemisection of the cervical spinal cord rostral to the level of the phrenic nucleus interrupts descending bulbospinal respiratory pathways, which results in a paralysis of the ipsilateral hemidiaphragm. In several mammalian species, functional recovery of the paretic hemidiaphragm can be achieved by transecting the contralateral phrenic nerve. The recovery of the paralyzed hemidiaphragm has been termed the “crossed phrenic phenomenon.” The physiological basis for the crossed phrenic phenomenon is as follows: asphyxia induced by spinal hemisection and contralateral phrenicotomy increases central respiratory drive, which activates a latent crossed respiratory pathway. The uninjured, initially latent pathway mediates the hemidiaphragm recovery by descending into the spinal cord contralateral to the hemisection and then crossing the midline of the spinal cord before terminating on phrenic motoneurons ipsilateral and caudal to the hemisection. The purpose of this study is to review work conducted on the crossed phrenic phenomenon and to review closely related studies focusing particularly on the plasticity associated with the response. Because the review deals with recovery of respiratory muscles paralyzed by spinal cord injury, the clinical relevance of the reviewed studies is highlighted.

Establishing phonation using the Blom®tracheostomy tube system: A report of three cases post cervical spinal cord injury

2016 ◽  
Vol 19 (4) ◽  
pp. 227-237 ◽  
Author(s):  
Lee N. Pryor ◽  
Elizabeth C. Ward ◽  
Petrea L. Cornwell ◽  
Stephanie N. O'Connor ◽  
Marianne J. Chapman
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Tracheostomy Tube ◽  
Cervical Spinal Cord ◽  
Cervical Spinal Cord Injury ◽  
Tube System ◽  
System A ◽  
Cord Injury

scholarly journals Restoration of breathing after opioid overdose and spinal cord injury using temporal interference stimulation

2021 ◽  
Vol 4 (1) ◽  
Author(s):  
Michael D. Sunshine ◽  
Antonino M. Cassarà ◽  
Esra Neufeld ◽  
Nir Grossman ◽  
Thomas H. Mareci ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Motor Neurons ◽  
Drug Overdose ◽  
Cervical Spinal Cord ◽  
Opioid Overdose ◽  
Electrode Position ◽  
Spinal Motor Neurons ◽  
Cord Injury ◽  
Low Amplitude

AbstractRespiratory insufficiency is a leading cause of death due to drug overdose or neuromuscular disease. We hypothesized that a stimulation paradigm using temporal interference (TI) could restore breathing in such conditions. Following opioid overdose in rats, two high frequency (5000 Hz and 5001 Hz), low amplitude waveforms delivered via intramuscular wires in the neck immediately activated the diaphragm and restored ventilation in phase with waveform offset (1 Hz or 60 breaths/min). Following cervical spinal cord injury (SCI), TI stimulation via dorsally placed epidural electrodes uni- or bilaterally activated the diaphragm depending on current and electrode position. In silico modeling indicated that an interferential signal in the ventral spinal cord predicted the evoked response (left versus right diaphragm) and current-ratio-based steering. We conclude that TI stimulation can activate spinal motor neurons after SCI and prevent fatal apnea during drug overdose by restoring ventilation with minimally invasive electrodes.

scholarly journals An Inertial Measurement Unit-Based Wireless System for Shoulder Motion Assessment in Patients with Cervical Spinal Cord Injury: A Validation Pilot Study in a Clinical Setting

Sensors ◽  
2021 ◽  
Vol 21 (4) ◽  
pp. 1057
Author(s):  
Riccardo Bravi ◽  
Stefano Caputo ◽  
Sara Jayousi ◽  
Alessio Martinelli ◽  
Lorenzo Biotti ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Clinical Setting ◽  
Cervical Spinal Cord ◽  
Wearable Sensors ◽  
Cervical Spinal Cord Injury ◽  
Measurement Unit ◽  
Innovative Technology ◽  
Inertial Measurement ◽  
Cord Injury

Residual motion of upper limbs in individuals who experienced cervical spinal cord injury (CSCI) is vital to achieve functional independence. Several interventions were developed to restore shoulder range of motion (ROM) in CSCI patients. However, shoulder ROM assessment in clinical practice is commonly limited to use of a simple goniometer. Conventional goniometric measurements are operator-dependent and require significant time and effort. Therefore, innovative technology for supporting medical personnel in objectively and reliably measuring the efficacy of treatments for shoulder ROM in CSCI patients would be extremely desirable. This study evaluated the validity of a customized wireless wearable sensors (Inertial Measurement Units—IMUs) system for shoulder ROM assessment in CSCI patients in clinical setting. Eight CSCI patients and eight healthy controls performed four shoulder movements (forward flexion, abduction, and internal and external rotation) with dominant arm. Every movement was evaluated with a goniometer by different testers and with the IMU system at the same time. Validity was evaluated by comparing IMUs and goniometer measurements using Intraclass Correlation Coefficient (ICC) and Limits of Agreement (LOA). inter-tester reliability of IMUs and goniometer measurements was also investigated. Preliminary results provide essential information on the accuracy of the proposed wireless wearable sensors system in acquiring objective measurements of the shoulder movements in CSCI patients.

scholarly journals Permanent diaphragmatic deficits and spontaneous respiratory plasticity in a mouse model of incomplete cervical spinal cord injury

2021 ◽  
Vol 284 ◽  
pp. 103568
Author(s):  
Pauline Michel-Flutot ◽  
Arnaud Mansart ◽  
Therese B. Deramaudt ◽  
Isley Jesus ◽  
Kun-Ze Lee ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Mouse Model ◽  
Cervical Spinal Cord ◽  
Cervical Spinal Cord Injury ◽  
Cord Injury ◽  
Respiratory Plasticity
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