AN INVESTIGATION OF THE PULMONARY FUNCTION OF PARAPLEGICS1

Abstract

Pulmonary function studies were made on 63 paraplegic patients with complete spinal transections, and 17 normal controls. The patients were divided into 3 groups: (1) those with lumbar spinal lesions who had paralysis of the lower limbs and pelvic floor but no paralysis of the muscles of breathing; (2) those with thoracic spinal lesions with paralysis of the lumbar muscles and lower intercostals; and (3) those with lower cervical spinal lesions with paralysis of all muscles of breathing except the diaphragm and the accessory muscles of respiration. Measurements were made of vital capacity and components, residual volume, maximum breathing capacity, arterial blood gases and pH, and ventilation during exercise. The vital capacity and maximum breathing capacity of patients with lumbar lesions were normal, while the group with lower cervical lesions had a vital capacity approximately 2/3 of normal and a maximum breathing capacity of 1/2 of normal. Paraplegics with thoracic lesions had vital capacities and maximum breathing capacities between the values for the cervical and lumbar lesions groups. The resting expiratory reserve volume expressed as a percentage of the vital capacity was below the normal percentage only for the group of paraplegics with cervical lesions. For this group the percentage value was 1/2 normal, which is higher than was anticipated for patients with only inspiratory muscle function. Residual volumes of all groups were significantly higher than the normal group. Arterial blood gases of all groups were normal and the ventilatory response to exercise for all groups of paraplegics did not differ from normal.