Intermittent positive-pressure breathing effects in patients with high spinal cord injury.
OBJECTIVE
To determine whether intermittent positive-pressure breathing (IPPB) improved lung compliance, work of breathing, and respiratory function in patients with recent high spinal cord injury (SCI).


METHODS
An unblinded randomized crossover trial.


METHODS
Rehabilitation hospital.


METHODS
Patients (N=14) with SCI caused by trauma within the last 6 months and located between C5 and T6.


METHODS
Two months of IPPB and 2 months of conventional treatment were evaluated prospectively in random order in patients with SCI.


METHODS
Noninvasive lung function tests and arterial blood gas measurements were obtained repeatedly in all patients. Repeated measurements of dynamic lung compliance and work of breathing as measured by computing the area enclosed between the inspiratory esophageal pressure-tidal volume curve, and the theoretical chest wall static pressure-volume curve were performed in 7 patients.


RESULTS
IPPB had no long-term effects on vital capacity (52.1%+/-11.3% vs 54.5%+/-12.5%, after conventional treatment and IPPB, respectively; P=.27), lung compliance (66.4+/-48.9 mL/cmH(2)O vs 70.3+/-38.4 mL/cmH(2)O; P=.56), or other lung function tests. IPPB did not exert short-term effects on lung compliance or work of breathing.


CONCLUSIONS
IPPB produced no immediate or long-term improvements in lung function or ventilatory mechanics in patients with recent SCI. (ClinicalTrials.gov identifier: NCT00476866.).
Laffont
Isabelle
I
Centre d'Investigation Clinique-Innovations Technologiques, Hôpital Raymond Poincaré, University of Versailles Saint Quentin en Yvelines, Garches, France.
Bensmail
Djamel
D
Lortat-Jacob
Sylvie
S
Falaize
Line
L
Hutin
Claudette
C
Le Bomin
Elisabeth
E
Ruquet
Maria
M
Denys
Pierre
P
Lofaso
Frédéric
F
D000293:Adolescent; D000328:Adult; D005260:Female; D006801:Humans; D007384:Intermittent Positive-Pressure Breathing; D008170:Lung Compliance / Q000502:physiology; D008297:Male; D008875:Middle Aged; D012129:Respiratory Function Tests; D013119:Spinal Cord Injuries / Q000503:physiopathology* / Q000534:rehabilitation; D014939:Work of Breathing / Q000502:physiology