Pulmonary function and sleep disordered breathing in patients with traumatic tetraplegia: a longitudinal study

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Study examining longitudinal changes in nocturnal blood gas tensions in 10 individuals with complete C4 to C7 motor quadriplegia who were at least 6 months postinjury. The mean age was 41.2 years and mean time since injury was 7.7 years at the initial evaluation. Subjects were reevaluated 5 years later, at a mean of 11.6 years postinjury. When initially evaluated, all subjects had normal daytime blood gases. However, 6 subjects (60%) had nocturnal oxyhemoglobin desaturations (dSATs) below 90%, 3 (30%) had mean nocturnal oxyhemoglobin saturation (SAT) below 90% for 10% or more of at least one hour, and 4 had maximum end tidal carbon dioxide tensions (EtCO2) greater than 45mmHg. At followup, subjects' vital capacities had improved significantly by a mean of 1242mL without treatment, and daytime blood gases were still normal for 9 of the 10 subjects. However, 5 subjects (50%) had an increased number of transient nocturnal dSATs and 8 of 9 (88%) restudied by capnography were hypercapnic. The results indicate that nocturnal dSAT and hypercapnia may be common in quadriplegia and may increase with age despite significant increases in vital capacity.

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