Every year, nearly 12,000 Americans experience spinal cord injuries (SCI) involving the upper portion of the spine, causing permanent quadriplegia.1 Respiratory complications are the leading cause of illness and death during both the acute and chronic phases after SCI; pulmonary problems contribute significantly to medical and care costs, suboptimal rehabilitation results and diminished quality of life.2
In SCI, the threats to lung health depend upon the level of the injury.3 In injuries involving the highest levels of the cervical spine (C2 and above), diaphragmatic, intercostal, and abdominal muscles are all paralyzed; mechanically assisted breathing is vital. At the level of C3 and below, partial or completely independent breathing is possible if diaphragm function is not impaired. However, in all injuries resulting in quadriplegia, or paralysis of all four limbs, respiratory function is significantly below normal. The risk for respiratory complications is very high. Assisted breathing and tracheostomy, or artificial airways, further increase the likelihood of developing lower respiratory tract infection, secretion retention, atelectasis, and respiratory failure.4
Individuals with high-level SCI experience the following problems:
- Restrictive pulmonary disease
- Ineffective cough
- Chronic aspiration
- Chronic respiratory insufficiency
- Respiratory failure
- Premature death
Without effective removal of retained secretions, SCI patients are caught in a spiral of progressive pulmonary decline. Many respiratory complications associated with SCI are preventable or treatable.5 A well-designed airway clearance regimen for individuals with SCI should help:
- Clear secretions effectively and consistently
- Enhance lung function
- Prevent or reduce atelectasis
- Prevent or reduce infectious exacerbations
- Reduce dependence upon antibiotic therapy and other medications
- Reduce need for hospitalization and auxiliary medical services
- Reduce medical care costs
- Reduce the burden of care
- Enhance quality of life
Airway Clearance with The Vest® System
The Vest® Airway Clearance System is an easy-to-use medical device for children and adults. The Vest® System is quiet, comfortable and portable. Its features promote user independence and simplify treatment routines.
The Vest® System uses a technology called High Frequency Chest Wall Oscillation (HFCWO). The Vest® System has an inflatable garment connected by Air Hoses to an Air Pulse Generator. During therapy, the inflatable garment inflates and deflates rapidly, applying gentle pressure to the chest wall. This works to loosen and thin mucus and to move it toward the larger airways, where it can be cleared by coughing or suctioning.
The Vest® System — Safe and Effective Therapy
HFCWO has been widely described in medical literature. More than 80 studies demonstrate the efficacy and safety of HFCWO for a variety of patients.
Learn more about clinical evidence and support:
- HFCWO (The Vest® System) Research
- Airway Clearance Needs in Spinal Cord Injury: An Overview - Jane Braverman (Hill-Rom Employee)
- Airway Clearance Requirements Among Patients With Mechanical Ventilation and Artificial Airways: An Overview - Jane Braverman (Hill-Rom Employee)
- Airway Clearance Needs in Neuromuscular Disease: An Overview - Jane Braverman (Hill-Rom Employee)
- National Spinal Cord Injury Statistical Center: www.spinalcord.uab.edu
- Lanig IS, Peterson WP. The respiratory system in spinal cord injury. Phys Med Rehabil Clin N Am 2000; 11 (1): 29-43.
- Bellemare JF, et al., Complications of traumatic care: risk analysis of pneumonia in 10,001 adult trauma patients. Am Surg. 1996 Mar; 62 (3): 207-11.
- 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 (11): 1411-1419.
- Mansel JK, Norman JR. Respiratory complications and management of spinal cord injuries. Chest 1990; 97 (6): 1446-1451.