Impact of cervical spinal cord injury on the relationship between the metabolism and ventilation in rats

2021 ◽  
Author(s):  
Tzu-Ting Chiu ◽  
Kun-Ze Lee
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Tidal Volume ◽  
Cervical Spinal Cord ◽  
Cervical Spinal Cord Injury ◽  
Male Rats ◽  
Whole Body ◽  
Post Injury ◽  
Chronic Injury ◽  
Cord Injury

Cervical spinal cord injury typically results in respiratory impairments. Clinical and animal studies have demonstrated that respiratory function can spontaneously and partially recover over time after injury. However, it remains unclear whether respiratory recovery is associated with alterations in metabolism. The present study was designed to comprehensively examine ventilation and metabolism in a rat model of spinal cord injury. Adult male rats received sham (i.e., laminectomy) or unilateral mid-cervical contusion injury (height of impact rod: 6.25 or 12.5 mm). Breathing patterns and whole-body metabolism (O2 consumption and CO2 production) were measured using a whole-body plethysmography system conjugated with flow controllers and gas analyzer at the acute (1 day post-injury), subchronic (2 weeks post-injury), and chronic (8 weeks post-injury) injury stages. The results demonstrated that mid-cervical contusion caused a significant reduction in the tidal volume. Although the tidal volume of contused animals can gradually recover, it remains lower than that of uninjured animals at the chronic injury stage. While O2 consumption and CO2 production were similar between uninjured and contused animals at the acute injury stage, these two metabolic parameters were significantly reduced in contused animals at the subchronic to chronic injury stages. Additionally, the relationships between ventilation, metabolism, and body temperature were altered by cervical spinal cord injury. These results suggest that cervical spinal cord injury causes a complicated reconfiguration of ventilation and metabolism that may enable injured animals to maintain a suitable homeostasis for adapting to the pathophysiological consequences of injury.

scholarly journals Tidal volume and diaphragm muscle activity in rats with cervical spinal cord injury

2015 ◽  
Vol 27 (3) ◽  
pp. 791-794 ◽  
Author(s):  
Hidetaka Imagita ◽  
Akira Nishikawa ◽  
Susumu Sakata ◽  
Yasue Nishii ◽  
Akira Minematsu ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Tidal Volume ◽  
Muscle Activity ◽  
Cervical Spinal Cord ◽  
Cervical Spinal Cord Injury ◽  
Diaphragm Muscle ◽  
Cord Injury

scholarly journals Serial plasma DNA levels as predictors of outcome in patients with acute traumatic cervical spinal cord injury

2019 ◽  
Vol 17 (1) ◽  
Author(s):  
Hung-Chen Wang ◽  
Yu-Tsai Lin ◽  
Shih-Yuan Hsu ◽  
Nai-Wen Tsai ◽  
Yun-Ru Lai ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Cervical Spinal Cord ◽  
Japanese Orthopaedic Association ◽  
Cervical Spinal Cord Injury ◽  
Acute Injury ◽  
Control Group ◽  
Plasma Dna ◽  
Post Injury ◽  
Cord Injury

Abstract Background Acute traumatic cervical spinal cord injury (SCI) is a leading cause of disability in adolescents and young adults worldwide. Evidence from previous studies suggests that circulating cell-free DNA is associated with severity following acute injury. The present study determined whether plasma DNA levels in acute cervical SCI are predictive of outcome. Methods In present study, serial plasma nuclear DNA (nDNA) and mitochondrial DNA (mtDNA) levels were obtained from 44 patients with acute traumatic cervical SCI at five time points from day 1 to day 180 post-injury. Control blood samples were obtained from 66 volunteers. Results Data showed a significant increase in plasma nDNA and mtDNA concentrations at admission in SCI patients compared to the control group. Plasma nDNA levels at admission, but not plasma mtDNA levels, were significantly associated with the Japanese Orthopaedic Association (JOA) score and Injury Severity Score in patients with acute traumatic cervical SCI. In patients with non-excellent outcomes, plasma nDNA increased significantly at days 1, 14 and 30 post-injury. Furthermore, its level at day 14 was independently associated with outcome. Higher plasma nDNA levels at the chosen cutoff point (> 45.6 ng/ml) predicted poorer outcome with a sensitivity of 78.9% and a specificity of 78.4%. Conclusions These results indicate JOA score performance and plasma nDNA levels reflect the severity of spinal cord injury. Therefore, the plasma nDNA assays can be considered as potential neuropathological markers in patients with acute traumatic cervical SCI.

scholarly journals Timely Intubation With Early Prediction of Respiratory Exacerbation in Acute Traumatic Cervical Spinal Cord Injury

2021 ◽  
Author(s):  
Takafumi Yonemitsu ◽  
Azuna Kinoshita ◽  
Keiji Nagata ◽  
Mika Morishita ◽  
Tomoyuki Yamaguchi ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Cervical Spinal Cord ◽  
Cervical Spinal Cord Injury ◽  
Post Injury ◽  
Airway Control ◽  
Airway Secretion ◽  
Respiratory Management ◽  
Cord Injury ◽  
Treatment Data

Abstract Background: Early routine intubation in motor-complete cervical spinal cord injury (CSCI) above the C5 level is a conventional protocol to prevent unexpected respiratory exacerbation (RE). However, in context of the recent advances in multidisciplinary respiratory management, the absolute indication for intubation in CSCI patients based on initial neurologic assessment is controversial because of the drawbacks of intubation. This study aimed to redetermine the most important predictor of RE following CSCI after admission without routine intubation among patients admitted with motor-complete injury and/or injury above the C5 level to ensure timely intubation. Methods: We performed a retrospective review of patients with acute traumatic CSCI admitted to our hospital without an initial routine intubation protocol from January 2013 to December 2017. CSCI patients who developed RE (defined as unexpected emergent intubation for respiratory resuscitation) were compared with those who did not. Baseline characteristics and severity of trauma data were collected. Univariate analyses were performed to compare treatment data and clinical outcomes between the two groups. Further, multivariate logistic regressions were performed with clinically important independent variables: motor-complete injury, neurologic level above C5, atelectasis, and copious airway secretion (CAS). Results: Among the analyzed 58 patients with CSCI, 35 (60.3%) required post-injury intubation and 1 (1.7%) died during hospitalization. Thirteen (22.4%) had RE in 3.5 days (mean) post-injury; 3 (37.5%) of eight motor-complete CSCI patients above C5 developed RE. Eleven of the 27 (40.7%) patients with motor-complete injury and five of the 22 (22.7%) patients with neurologic injury above C5 required emergency intubation at RE. Three of the eight CSCI patients with both risk factors (motor-complete injury above C5) resulted in emergent RE intubation (37.5%). CAS was an independent predictor for RE (odds ratio 7.19, 95% confidence interval 1.48–42.72, P=0.0144) in multivariate analyses. Conclusion: Timely intubation post-CSCI based on close attention to CAS during the acute 3-day phase may prevent RE and reduce unnecessary invasive airway control even without immediate routine intubation in motor-complete injury above C5.

scholarly journals The experiences of individuals with cervical spinal cord injury and their family during post-injury care in non-specialised and specialised units in UK

2020 ◽  
Author(s):  
Jackie McRae ◽  
Christina Smith ◽  
Anton Emmanuel ◽  
Suzanne Beeke
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Cervical Spinal Cord ◽  
Family Members ◽  
Cervical Spinal Cord Injury ◽  
Specialist Care ◽  
Structured Interviews ◽  
Post Injury ◽  
Experience Of Care ◽  
Cord Injury

Abstract Background Individuals with acute cervical spinal cord injury require specialised interventions to ensure optimal clinical outcomes especially for respiratory, swallowing and communication impairments. This study explores the experiences of post-injury care for individuals with cervical spinal cord injury and their family members during admissions in specialised and non-specialised units in the United Kingdom.Methods Semi-structured interviews were undertaken with individuals with a cervical spinal cord injury and their family member, focussing on the experience of care across units. Eight people with spinal cord injury levels from C2 to C6, were interviewed in their current care settings. Six participants had family members present to support them. Interviews were audio-recorded and transcribed with data inputted into NVivo for thematic analysis.Results The study identified six themes from the participant interviews that highlighted different experiences of care in non-specialised and specialised settings. A number of these were related to challenges with the system, whilst others were about the personal journey of recovery. The themes were titled as: adjustment, transitions, “the golden opportunity”, “when you can’t eat”, communication, and “in the hands of the nurses and doctors”.Conclusions Whilst participants reported being well cared for in non-specialised units, they felt that they did not receive specialist care and this delayed their rehabilitation. Participants were dependent on healthcare professionals for information and care and at times lost hope for recovery. Staff in non-specialised units require training and guidance to help provide support for those with dysphagia and communication difficulties, as well as reassurance to patients and families whilst they wait for transfer to specialised units.

scholarly journals Mild Acute Intermittent Hypoxia Improves Respiratory Function in Unanesthetized Rats With Midcervical Contusion

2016 ◽  
Vol 31 (4) ◽  
pp. 364-375 ◽  
Author(s):  
Kun-Ze Lee ◽  
Shu-Chi Chiang ◽  
Yu-Jie Li
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Tidal Volume ◽  
Respiratory Function ◽  
Intermittent Hypoxia ◽  
Differential Forms ◽  
Male Rats ◽  
Whole Body ◽  
Sham Surgery ◽  
Cord Injury

Background. Mild intermittent hypoxia has been considered a potential approach to induce respiratory neuroplasticity. Objective. The purpose of the present study was to investigate whether mild acute intermittent hypoxia can improve breathing function in a clinically relevant spinal cord injury animal model. Methods. Adult male rats received laminectomy or unilateral contusion at the C3-C4 spinal cord using a MASCIS Impactor (height: 6.25 or 12.5 mm). At 4 weeks postinjury, the breathing patterns of unanesthetized rats were measured by whole body plethysmography before, during and after 10 episodes of 5 minutes of hypoxia (10% O2, 4% CO2, balance N2) with 5 minutes of normoxia intervals. Results. The results demonstrated that cervical contusion resulted in reduction in breathing capacity and number of phrenic motoneurons. Acute hypoxia induced significant increases in frequency and tidal volume in sham surgery and contused animals. In addition, there was a progressive decline in the magnitude of hypoxic ventilatory response during intermittent hypoxia. Further, the tidal volume was significantly enhanced in contused but not sham surgery rats at 15 and 30 minutes postintermittent hypoxia, suggesting intermittent hypoxia can bring about long-term facilitation of tidal volume following cervical spinal contusion. Conclusions. These results suggest that mild acute intermittent hypoxia can elicit differential forms of respiratory plasticity in sham surgery versus contused animals, and may be a promising neurorehabilitation approach to improve respiratory function after cervical spinal cord injury.

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