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Respiratory Management Following Spinal Cord Injury
Presenter: Thomas Kiser, MD, MPH
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Knowledge Gap: 
The purpose of this activity is to educate healthcare providers with the most up-to-date information on Respiratory Management Following Spinal Cord Injury.

Target Audience
The target audience includes all healthcare professionals such as physicians, nurses, pharmacists and allied health professionals who would like to learn about Respiratory Management Following Spinal Cord Injury and how it pertains to their respective profession.

 
Release and Expiration Dates
4/4/2017 - 4/4/2020

Objectives

  1. Learn why respiratory management is critical to the health and quality of life in Spinal Cord Injury (SCI).
  2. Understand treatment methods to manage respiratory function in people living with SCI.
  3. Discuss the appropriate patient education to prevent respiratory complications.

Biographical Info

Thomas Kiser, MD, is Professor of the Department of Physical Medicine and Rehabilitation at the University of Arkansas for Medical Sciences and is Arkansas Spinal Cord Commission Medical Director. Kiser's professional certifications are the American Board of Physical Medicine and Rehabilitation, and Spinal Cord Medicine.

He has worked actively in various aspects of rehab for more than 20 years.

 Currently Kiser practices at the University of Arkansas for Medical Sciences Physical medicine and rehabilitation department in the Jackson T. Stephens Spine and Neurosciences Institute and Baptist Health Rehabilitation Institute. 

 





 


 

References

 [1] Consortium for Spinal Cord Medicine. (2005). Respiratory Management Following Spinal Cord Injury: A clinical practice guideline for health-care professionals. Journal of Spinal Cord Medicine.

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[1] Berlly M, Shem K. Respiratory Management during the First Five Days after Spinal Cord Injury. J Spinal Cord Med. 2007;30:310.

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[1] Montgomerie, J. Z. Infections in patients with spinal cord injuries. Clinical Infectious Diseases,25 (1997), 1285-1290.

[1] Aubier, M., DeTroyer, A., Sampson, M., Macklem, P. T., & Roussos, C. Aminophylline Improves Diaphragmatic Contractility. New England Journal of Medicine,305(22) (1981), 1349-1350.

[1] Murciano, D., Aubier, M., Lecocguic, Y., & Pariente, R. Effects of theophylline on diaphragmatic strength and fatigue in patients with chronic obstructive pulmonary disease. New England Journal of Medicine,311(6) (1984), 349-353.

[1] Foxworth, J. W., Reisz, G. R., Knudson, S. M., Cuddy, P. G., Pyszczynski, D. R., & Emory, C. E. Theophylline and diaphragmatic contractility: investigation of a dose-response relationship. American Review of Respiratory Disease,138(6) (1988), 1532-1534.

[1] Spungen, A. M., Grimm, D. R., Strakhan, M., Pizzolato, P. M., & Bauman, W. A. Treatment with an anabolic agent is associated with improvement in respiratory function in persons with tetraplegia: a pilot study. Mount Sinai Journal of Medicine,66 (1999), 201-205.

[1] Peterson, W. P., Barbalata, L., Brooks, C. A., Gerhart, K. A., Mellick, D. C., & Whiteneck, G. G. The effect of tidal volumes on the time to wean persons with high tetraplegia from ventilators. Spinal Cord,37(4) (1999), 284-288.

[1] Massaro, G. D., Massaro, D. Morphologic evidence that large inflations of the lung stimulate secretion of surfactant. Am Rev Respir Dis, 127(2) (1983), 235-236.

[1] Peterson P, Brooks CA, Mellick D, Whiteneck G. Protocol for ventilator management in high tetraplegia. Top Spinal Cord Inj Rehabil. 1997:2:101–106.

[1] Fenton JJ, Warner ML, Lammertse D, Charlifue S, Martinez L, Dannels-McClure A, Kreider S, Pretz C.  A Comparison of high vs standard tidal volumes in ventilator weaning for individuals with sub-acute spinal cord injuries: a site-specific randomized clinical tria.l Spinal Cord (2016) 54, 234–238.

[1] Bach JR. Noninvasive respiratory management of high level spinal cord injury. J Spinal Cord Med. 2012;35:72-80

[1] Matsumoto, T., Tamaki, T., Kawakami, M., Yoshida, M., Ando, M., & Yamada, H. Early complications of high-dose methylprednisolone sodium succinate treatment in the follow-up of acute cervical spinal cord injury. Spine, 26(4) (2001), 426-430.

[1] Berlly M, Shem K. Respiratory Management during the First Five Days after Spinal Cord Injury. J Spinal Cord Med. 2007;30:316-17.

[1] Bach JR. Noninvasive respiratory management of high level spinal cord injury. J Spinal Cord Med. 2012;35:72-80.

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[1] Hoh DJ, Mercier LM, Hussey SP, Lane MA.Respiration following Spinal Cord Injury: Evidence for Human Neuroplasticity. Respir Physiol Neurobiol. 2013 November 1; 189(2): . doi:10.1016/j.resp.2013.07.002.

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[1] Onders RP, Elmo M, Khansarinia S, Bowman B, Yee J, Road J, Bass B, Dunkin B, Ingvarsson PE, Oddsdottir M. Complete worldwide operative experience in laparoscopic diaphragm pacing: results and differences in spinal cord injured patients and amyotrophic lateral sclerosis patients. Surg Endosc. 2009; 23:1433–1440.

[1] Romero FJ, Gambarrutta C, Garcia-Forcada A, Marin MA, Diaz de la Lastra E, Paz F, Fernandez-Dorado MT, Mazaira J. Long-term evaluation of phrenic nerve pacing for respiratory failure due to high cervical spinal cord injury. Spinal Cord. 2012; 50:895–898.

[1] Aldrich TK, Karpel JP, Uhrlass RM, Sparapani MA, Eramo D, Ferranti R. Weaning from mechanical ventilation: adjunctive use of inspiratory muscle resistive training. Crit Care Med. 1989; 17:143–147.

[1] Cader SA, Vale RG, Castro JC, Bacelar SC, Biehl C, Gomes MC, Cabrer WE, Dantas EH. Inspiratory muscle training improves maximal inspiratory pressure and may assist weaning in older intubated patients: a randomized trial. J Physiother. 2010; 56:171–177.

[1] Martin AD, Smith BK, Davenport PD, Harman E, Gonzalez-Rothi RJ, Baz M, Layon AJ, Banner MJ, Caruso LJ, Deoghare H, Huang TT, Gabrielli A. Inspiratory muscle strength training improves weaning outcome in failure to wean patients: a randomized trial. Crit Care. 2011; 15:R84.

[1] Fuller DD, Bach KB, Baker TL, Kinkead R, Mitchell GS. Long term facilitation of phrenic motor output. Respir Physiol. 2000; 121:135–46.

[1] Golder FJ, Mitchell GS. Spinal synaptic enhancement with acute intermittent hypoxia improves respiratory function after chronic cervical spinal cord injury. J Neurosci. 2005; 25:2925–2932.

[1] Rymer WZ, Hornby T, Mitchell GS, Schmit BD, Trumbower RD. Effects of intermittent hypoxia on motor function in persons with incomplete SCI. Soc Neuro. 2007:Abstract. 82.18/LL2.

[1] Hayes HB, Jayaraman A, Herrmann M, Mitchell GS, Rymer WZ, Trumbower RD. Daily intermittent hypoxia enhances walking after chronic spinal cord injury. Neurology 2014;82:104–11.

[1] DiMarco AF. Restoration of respiratory muscle function following spinal cord injury: Review of electrical and magnetic stimulation techniques. Respiratory Physiology & Neurobiology. 2005 Jul 28; 147(2–3):273–287.

[1] DiMarco AF, Kowalski KE, Supinski G, Romaniuk JR. Mechanism of expiratory muscle activation during lower thoracic spinal cord stimulation. J Appl Physiol. Jun 1.2002 92:2341–2346.

[1] DiMarco AF, Kowalski KE. Effects of chronic electrical stimulation on paralyzed expiratory muscles. J Appl Physiol. 2008 Jun; 104 (6):1634–40.

[1] Darouiche, R. Pneumococcal vaccination for patients with spinal cord injury,. Archives of Physical Medicine and Rehabilitation,74(12) (1993), 1354-1357.

[1] Waites, K. B., Canupp, K. C., Edwards, K., Palmer, P., Gray, B. M., & Vivo, M. J. Immunogenicity of pneumococcal vaccine in persons with spinal cord injury. Archives of Physical Medicine and Rehabilitation,79(12) (1998), 1504-1509.






 

 

Speaker Disclosures:
The planners, speakers, moderators, peer reviewers and /or panelists of this CE activity have no relevant financial relationships with commercial interests to disclose.

Planners: 
Kim Miller
Sarah Rhoads 
Susan Smith Dodson
Mark Jansen

Speaker:
Thomas Kiser, MD, MPH

Peer Reviewers: 
Kim Miller, MCHES


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           You may retake the post-test if you do not receive a passing score.
5.       Complete Evaluation 
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The University of Arkansas for Medical Science Office of Continuing Education designates this live activity for a maximum of 1.00 AMA PRA Category 1 CreditsTM. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

 

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It is the policy of the University of Arkansas for Medical Sciences (UAMS) College of Medicine to ensure balance, independence, objectivity, and scientific rigor in all directly or jointly provided educational activities. All individuals who are in a position to control the content of the educational activity (course/activity directors, planning committee members, staff, teachers, or authors of CE) must disclose all relevant financial relationships they have with any commercial interest(s) as well as the nature of the relationship. Financial relationships of the individual’s spouse or partner must also be disclosed, if the nature of the relationship could influence the objectivity of the individual in a position to control the content of the CE. The ACCME describes relevant financial relationships as those in any amount occurring within the past 12 months that create a conflict of interest. Individuals who refuse to disclose will be disqualified from participation in the development, management, presentation, or evaluation of the CE activity.

 

 



Type:  Internet Activity (Enduring Material)
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