Pulmonary Function, Ventilatory Control, and Respiratory Complications in Quadriplegic Subjects1, 2

Eight subjects with traumatic transection of the cervical cord and quadriplegia were studied. Vital capacities ranged from 36 per cent to 91 per cent of predicted, and there was no evidence of airway obstruction. Arterial blood gases and dynamic pulmonary compliance were normal. The thoracic component of ventilation ranged from 22 per cent to 90 per cent of total ventilation. This thoracic component was attributed to use of accessory muscles of breathing. Five of the subjects neither sighed nor were able to detect an elastic load to inspiration. These 5 experienced repeated respiratory complications. Three of the subjects sighed and were able to detect an elastic load; these 3 had been free of respiratory complications. The results suggest that preservation of the respiratory control system is more vital to freedom from respiratory complications than is preservation of vital capacity Special efforts directed toward sighing and detection of loads to ventilation may be valuable in preventing respiratory com...