SCI-08 · Respiratory Management

Respiratory Management. Part of the Spinal Cord Injury series of the Reflex PM&R Board Review podcast. Audio corrections: (1) In the audio: If we start at the top, for a complete C1 or C2 injury, the weaning success rate is about 0%. — Correct: C1 and C2 do not share one rate. In neurologically complete injury the reported weaning success is 0 percent at C1 but 0 to 28 percent at C2, so a motor-complete C2 patient is not automatically a never-weaner. (2) In the audio: For a complete C3 injury, the weaning success rate is about 50%. — Correct: 50 percent is the top of the reported range, not the central estimate. Reported weaning success at a neurologically complete C3 is 25 to 50 percent. (3) In the audio: For a complete C4 injury, the weaning success rate is about 75%. — Correct: Reported weaning success at a neurologically complete C4 is 77 to 83 percent, slightly above the figure given. (4) In the audio: For C5 and below, the weaning success rate is approaching 100%. — Correct: No source endorses a rate approaching 100 percent. The supported statement is that most C5 and C6 injuries breathe without mechanical assistance, because diaphragm function is preserved. Reported cohorts of ventilated cervical injury wean roughly 79 to 85 percent overall. (5) In the audio: And critically, weaning success varies strictly by level. — Correct: The level-by-level rates are cohort figures from reported series. They set the expectation for a motor-complete examination; they do not fix an individual outcome, which still turns on diaphragm function, recovery, nutrition, endurance and comorbidity. The written chapter is correct. Full correction register: https://www.reflexpmr.com/errata. The full companion chapter and a linked board-style Q-bank set for this topic are at https://www.reflexpmr.com/read/SCI-08.