Respiratory problems after high cervical spine injury

Respiratory failure plays a major role in morbidity and mortality after high cervical spine injury. Initially the patients are threatened by acute loss of motor function of the respiratory muscles and the development of neurogenic pulmonary edema. In the further course alterations in the mechanical properties of the respiratory system, changes in lung function, pulmonary infections and airway problems are the main reasons for life threatening respiratory failure. Early surgical stabilization, careful weaning from mechanical ventilation, meticulous search and treatment of infections, aggressive posturing and mobilization and support of impaired mechanical functions by physiotherapy, muscle training, noninvasive respiratory support and in some cases electrophrenic pacing increase survival and independency of quadriplegic patients.