Aspiration pneumonia is a dangerous complication that develops in some individuals with spinal cord injury. The ability to swallow, clear one’s throat, cough, take a deep breath, and ensure that when eating, fluid and liquid go down “the right way” is controlled by nerves that exit the cervical spine in the neck.
When these nerves are damaged, small to large amounts of liquid and food can slip into the lungs. While this would normally cause an individual to start reflexively coughing, a spinal cord injury victim may not be able to cough, or may not have an adequate cough reflex.
Spinal cord victims may also be unable to take a deep breath and clear normal secretions from the upper respiratory tract and throat.
Fluid Buildup
Fluid or mucus in the lungs creates an ideal environment for bacteria to multiply. Bacteria settle into all areas where there is excess moisture; this stimulates an immune response which includes inflammation and secretion of cellular fluids. The body naturally increases mucus production in order to help flush out the infection. Unfortunately, the spinal cord injured are not able to clear these secretions and the lungs begin to fill, making breathing difficult and dropping oxygenation. This can progress rapidly and be life threatening.
Intravenous antibiotics and being placed on a ventilator are usually necessary. How long a ventilator is needed depends on the severity of the infection, degree of lung inflammation and amount of mucous. Aggressive suctioning down into the lungs removes mucous and pockets of infection. Aspiration pneumonia often requires several days in the intensive care unit.
Lifelong Needs
Over the lifetime of a spinal cord injury patient, there can me multiple infections and hospitalizations. A life care plan needs to integrate the current rates of aspiration pneumonia and plan for long-terms costs which will likely increase with aging. Dr. Greg Vigna, a rehabilitation doctor and personal injury attorney, integrates all possible complications into your case so your life-long needs are taken care of.
Pneumonia graphic courtesy of David Dorward; Ph.D.; National Institute of Allergy and Infectious Diseases (NIAID)
