HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text (PDF) Correspondence: Submit a response Alert me when this article is cited Alert me when Correspondence are posted Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by GOLDMAN, A. L. Articles by GEORGE, J. Search for Related Content PubMed PubMed Citation Articles by GOLDMAN, A. L. Articles by GEORGE, J.

Postural hypoxemia in quadriplegic patients

From the Pulmonary Disease Section, Department of Internal Medicine, and Spinal Cord Injury Service, Tampa Veterans Administration Hospital, and the University of South Florida College of Medicine, Tampa.

Quadriplegic patients frequently undergo unusual positional changes, including head-down tilt. To determine if hypoxemia develops in this position and whether it is related to the duration of quadriplegia, five patients were studied within 1 year of injury (group A) and five after 1 year from injury (group B). Arterial blood gases were obtained in the seated and 45-degree head-down position. Group A patients had a decrease in arterial partial pressure of oxygen in the head-down position (p <0.025), while group B patients did not (p >0.4). This study demonstrated that quadriplegic patients have positional hypoxemia early in their course. This probably results from relative hypoventilation of the upper lung fields caused by flaccid paralysis of the intercostal muscles. The positional hypoxemia disappears with time, presumably because of the change from flaccid to spastic paralysis of the intercostal muscles.

Reprint requests should be addressed to Dr. Goldman, Chief, Pulmonary Disease Section, Tampa Veterans Administration Hospital, 13000 North 30th Street, Tampa, FL 33612.

Received for publication December 15, 1975.

This article has been cited by other articles:

				J Bott, S Blumenthal, M Buxton, S Ellum, C Falconer, R Garrod, A Harvey, T Hughes, M Lincoln, C Mikelsons, et al. Guidelines for the physiotherapy management of the adult, medical, spontaneously breathing patient Thorax, May 1, 2009; 64(Suppl_1): i1 - i52. [Full Text] [PDF]