Acute effects of glossopharyngeal insufflation in people with cervical spinal cord injury.

OBJECTIVES

To evaluate acute effects of glossopharyngeal insufflation (GI) on lung function, airway pressure (P), blood pressure and heart rate (HR) in people with cervical spinal cord injury (CSCI).

DESIGN

Case-control design.

SETTING

Karolinska Institutet, Stockholm, Sweden.

PARTICIPANTS

Ten participants with CSCI suffering from lesions between C4 and C8, and ASIA classification of A or B were recruited. Ten healthy particpants familiar with GI were recruited as a reference group.

OUTCOME MEASURES

Spirometry, mean arterial blood pressure (MAP), P and HR were measured in a sitting and a supine position before, during, and after GI.

RESULTS

GI in the study group in a sitting position increased total lung capacity (TLC) by 712 ml: P < 0.001, vital capacity (VC) by 587 ml: P < 0.0001, P by 13 cm HO: P < 0.01, and HR by 10 beats/min: P < 0.001. MAP decreased by 25 mmHg, P < 0.0001. Significant differences were observed between groups comparing baseline with GI. The reference group had a higher increase in; TLC (P < 0.01), VC (P < 0.001), P (P < 0.001) and HR (P < 0.05) and a higher decrease in MAP (P < 0.001). With GI in a sitting compared to a supine position, TLC, MAP, HR, P remained unchanged in the study group, while residual volume decreased in the supine position (P < 0.01).

CONCLUSION

There was a difference between the groups in the increase in TLC; VC; P HR and in the decrease in MAP with GI, however MAP, HR and P responded in similar way in both groups in a sitting as well as a supine position. If performed correctly, the risks of GI resulting in clinically significant hemodynamic changes is low, although syncope may still occur.