Can-SCIP Coach App
  1. Can-SCIP
  2. Recommendations
  3. Guidelines
  4. Section 2 - MANAGEMENT OF SCI COMPLICATIONS

Q - RESPIRATORY




Q.1.1
Individuals with SCI in an inpatient rehabilitation setting should be screened for sleep-disordered breathing, and treated prior to discharge to the community. (CAN-SCIP 2020; Level C)


Q.2.1
We recommend an abdominal binder to improve pulmonary function among individuals with a neurological level of injury of C1 to T11. (CAN-SCIP 2020; Level B)
Q.2.2
Electrical abdominal muscle stimulation may be offered to improve cough function only in the context of a supervised research trial. (CAN-SCIP 2020; Level C)


Q.3.1
Inhaled Beta-2 agonists in individuals with tetraplegia and impaired respiratory function with a component of obstructive airway impairment is recommended. (CAN-SCIP 2020; Level B)


Q.4.1
Clinicians should introduce routine upper limb exercise and respiratory muscle training for all individuals with a T12 injury and higher to improve respiratory muscle strength and function. (CAN-SCIP 2020; Level C)


Q.5.1
Individual with cervical or thoracic SCI should be evaluated for long-term ventilation support when appropriate. Non-invasive respiratory support is the preferred mode for individuals with SCI and respiratory insufficiency. (Adapted from CTS 2011, p.13; Level C)
Q.5.2
Phrenic nerve pacing and diaphragmatic pacing in select individuals as an alternative to positive pressure ventilation (PPV) alone. (Adapted from CTS 2011; p.13; Level C)
Q.5.3
Individuals with cervical or thoracic SCI require regular assessment to identify the loss of lung volume, retention of respiratory secretions, development of sleep-disordered breathing, and ventilatory failure, to evaluate the need for cough assist techniques and nocturnal positive pressure support. (Adapted from CTS 2011, p.13; Level C)
Q.5.4
Individuals with cervicothoracic SCI and evidence of respiratory impairment should receive regular airway clearance techniques, lung volume recruitment (i.e., manually assisted coughing and mechanical in-exsufflation) and ongoing monitoring of pulmonary function to ensure adequate airway clearance. (Adapted from CTS 2011, p.13; Level C)