Hemodynamic Management of Acute Spinal Cord Injury: A Literature Review.

Neurospine
Young-Seok LeeBrian K Kwon

Abstract

The goal of acute spinal cord injury (SCI) management is to reduce secondary injuries and improve neurological recovery after its occurrence. This review aimed to explore the literature regarding hemodynamic management to reduce ischemic secondary injury and improve neurologic outcome following acute SCI. The PubMed database was searched for studies investigating blood flow, mean arterial pressure (MAP), and spinal cord perfusion pressure after SCI. The 2013 guidelines of the American Association of Neurological Surgeons/Congress of Neurological Surgeons recommended maintaining MAP at 85-90 mmHg for 7 days after SCI to potentially improve outcome. However, this recommendation was based on weak evidence for neurologic benefit. The maintenance of MAP will typically require vasopressors, which may have their own set of complications. More recently, studies have suggested the potential importance of considering spinal cord perfusion pressure in addition to the MAP. Further research on the hemodynamic management of acute SCI is required to determine how to optimize neurologic recovery. Evidence-based guidelines for hemodynamic management should acknowledge the gaps in knowledge and the limitations of the current literature.

References

Jul 17, 2013·Neurosurgery·Beverly C WaltersUNKNOWN Congress of Neurological Surgeons
Feb 4, 2014·Critical Care : the Official Journal of the Critical Care Forum·Samer MelhemA Kaynar
Aug 1, 2015·Journal of Neurosurgery. Spine·William J ReaddySanjay S Dhall
Aug 15, 2015·Journal of Neurosurgery. Spine·Georgios V VarsosMarek Czosnyka

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Citations

Apr 6, 2021·Neurospine·Nader Hejrati, Michael G Fehlings
May 1, 2021·International Journal of Molecular Sciences·Hye-Lan LeeKeung-Nyun Kim

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