PEDIATRICS Vol. 82 No. 5 November 1988, pp. 741-745
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Neck Breathing: A Form of Voluntary Respiration for the Spine-Injured Ventilator-Dependent Quadriplegic Child

Irene S. Gilgoff MD1, Donna M. Barras MD1, Michelle Sellers Jones RPT1, and Hazel V. Adkins RPT1

1 From the Department of Pediatrics, Rancho Los Amigos Medical Center, Downey, California

Children with respirator-dependent quadriplegia because of C-2 spinal cord injuries are now surviving the acute stages of their injury. The major cause of mortality and morbidity in the chronic stage is due to respiratory complications. Surveillance, 24 h/d, is the best way to prevent accidental disconnection of respirator equipment from the patient and its inherent catastrophic consequences. The constant risk of disconnection adds tension to the home environment and takes away from the patient any degree of independence or privacy. Because of this, an alternative method of respiration using neck accessory muscles was developed to restore a patient-controlled, voluntary system of respiration. This method, neck breathing, is described in detail in seven children varying in age from 3 years to 16 years 3 months. All seven patients had complete paralysis of the intercostal muscles and the diaphragm. An eighth patient who was unable to learn the technique is also described. Neck breathing is also compared to glossopharyngeal breathing, an alternative method of respiration developed during the polio era.

Key Words: neck breathing • spine injury • quadriplegia • mechanical ventilator

Submitted on January 28, 1987
Accepted on August 11, 1987




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 Neurorehabil Neural RepairHome page
R. Padman, M. Alexander, C. Thorogood, and S. Porth
Respiratory Management of Pediatric Patients with Spinal Cord Injuries: Retrospective Review of the duPont Experience
Neurorehabil Neural Repair, March 1, 2003; 17(1): 32 - 36.
[Abstract] [PDF]