Respiratory complications often result from acute spinal cord injury. Ventilatory assistance/support is often required 12 hours to 6 days after admission and is typically delivered via translaryngeal tubes. When not weanable from ventilatory support, tracheostomy tubes are placed. Supplemental O2 is often provided irrespective of whether or not the patient is hypoxic. This renders the oximeter ineffective as a gauge of alveolar ventilation, airway secretion management, and residual lung disease, and can exacerbate hypercapnia. Thus, hypoventilation and airway secretions must be effectively treated to prevent lung disease and to maintain normal O2 saturation and CO2 levels without supplemental O2.