Respiratory Infections After SCI

Respiratory infections can quickly overwhelm your body, making breathing impossible and spreading dangerous bacteria to your blood and brain. These infections are so dangerous that they rank among the leading causes of death worldwide. Among spinal cord injury (SCI) survivors, respiratory infections are especially dangerous, killing more SCI survivors than any single other cause.

You don't have to live in fear of respiratory infections after a spinal cord injury. Instead, learning all you can about how spinal cord injuries affect the respiratory system can help you avoid developing an infection, while empowering you to at quickly if you're unlucky enough to experience an infection.  

How a Spinal Cord Injury Affects the Respiratory System

The primary risk to the respiratory system after SCI occurs when the injury impedes your ability to independently breathe, swallow, or cough. The higher the injury, the more likely it is that you will experience breathing difficulties that necessitate the use of artificial respirators. These breathing devices are themselves a risk factor for respiratory infections, since the equipment can become infected with dangerous bacteria.

Even if your spinal cord injury is low enough that you're able to breathe on your own, you may still experience changes in your respiratory system. You'll likely be getting less exercise, which means your lungs and heart may become weaker. Treatment for your injury may also undermine respiratory health, or make it difficult to breathe on your own.

Why Spinal Cord Injuries Are a Risk Factor for Respiratory Infections

Although anyone can get a respiratory infection, particularly after an injury or other illness, SCI survivors are especially vulnerable. The unique risk factors SCI survivors face include:

• Decreased immunity after the injury. Drugs your providers give you, as well as your body's natural immune response to your injury, may both reduce your ability to fight off a respiratory infection. 
• Prolonged periods of time lying down or sitting. This can allow fluid to accumulate in your lungs. 
• Exposure to bacteria at hospital and rehabilitation facilities. When you spend a significant portion of your time at a place where sick people congregate, you're more likely to contract a serious infection. 
• The inability to control your respiratory tract. If you cannot cough, breathe, or swallow, you're less adept at dislodging irritants and bacteria. 
• Artificial respiratory devices. If not diligently cleaned, these products can accumulate dangerous bacteria that can lead to a dangerous infection. 

How Respiratory Infections Harm the Body

Your lungs oxygenate your blood, allowing it to nourish every organ in your body. Without proper oxygenation, you can quickly suffer brain damage and multi-organ failure. When you develop a respiratory infection, you may not breathe as effectively, reducing blood oxygen. In severe cases, you may be unable to breathe at all. Some respiratory infections—even apparently minor ones—can also spread to other areas of the body.

When Respiratory Infections Spread

When a respiratory infection spreads to another organ, the infection becomes significantly more difficult to treat. This is especially true for SCI survivors, who already struggle with decreased immunity, and who may have additional health problems. The more rapidly the infection spreads, the more easily your body can become overwhelmed. Even if the infection is promptly treated, it's possible to suffer serious and lasting organ, tissue, and muscle damage. This is why it's so important to tell your doctor immediately if you experience other symptoms alongside a respiratory infection, even if those symptoms seem relatively minor.

Signs and Symptoms of Respiratory Infections

Many respiratory infections start out very minor, just like the common cold. But if you have a spinal cord injury, even minor infections can escalate quickly. Signs to immediately report to your doctor include:

• Swollen lymph nodes in your neck. 
• A feeling of fullness in your chest. 
• Frequent coughing.
• Congestion. 
• Burning in your throat. 
• Difficulty or pain when swallowing. 
• Unusual rashes or growths. 
• A fever, even if accompanied by no other symptoms. 
• Coughing up more mucous than usual, or mucous that is green. 
• Difficulty breathing when lying down or sleeping. 

Treatment of Respiratory Infections

Respiratory infections come in two basic forms: viral and bacterial. Viral infections typically must run their course, and cannot be treated with antibiotics. If you have a viral infection, your doctor will carefully monitor you, and may provide treatment to reduce your symptoms. Occasionally, viral infections turn into bacterial infections, so ask your doctor what to look for. If you suddenly get worse or develop a fever, tell your doctor immediately.

Bacterial infections can be treated with antibiotics, and treatment works best if the infection is detected early. Severe infections may warrant intravenous antibiotics and a hospital stay. Rarely, if the infection is resistant to antibiotics, your doctor might have to try several antibiotics, or provide supportive care until your immune system addresses the infection on its own.

Prevention of Respiratory Infections

It's not your fault if you get a respiratory infection. We live in a world filled with bacteria and viruses that are nearly impossible to avoid. Nevertheless, a number of strategies can help you reduce your odds of developing a respiratory infection. Those include:

• Remaining upright as frequently as possible.
• Coughing frequently, even if you feel no urge to do so.
• Keeping any respiratory equipment you use clean; your doctor can advise you about proper cleaning techniques, and you should religiously adhere to the protocols he or she advises.
• Obtaining an annual flu vaccination, and remaining up to date on all other vaccines, most notably the pneumonia vaccination.
• Exercising as advised by your doctor.
• Drinking plenty of water, particularly if you feel congested or already have an infection.
• Quitting smoking, avoiding smokers, and steering clear of places where secondhand smoke is abundant.
• Staying out of polluted areas, and avoiding areas with air quality warnings.
• Avoiding inhaled substances to which you are allergic.
• Practicing diligent hand-washing, particularly when you are around people who might be stick.
• Staying in the hospital only as long as is absolutely necessary.
• Asking loved ones who are sick to avoid visiting you.
• Avoiding air travel during cold and flu season.
• Wearing an abdominal binder to support your abdominal muscles and enable you to more effectively cough.
• Following any other treatment protocols your doctor recommends.