The impact of blood pressure management after spinal cord injury: a systematic review of the literature

Neurosurgical Focus
Yamaan S SaadehPaul Park

Abstract

OBJECTIVE Spinal cord injury (SCI) results in significant morbidity and mortality. Improving neurological recovery by reducing secondary injury is a major principle in the management of SCI. To minimize secondary injury, blood pressure (BP) augmentation has been advocated. The objective of this study was to review the evidence behind BP management after SCI. METHODS This systematic review was conducted following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Using the PubMed database, the authors identified studies that investigated BP management after acute SCI. Information on BP goals, duration of BP management, vasopressor selection, and neurological outcomes were analyzed. RESULTS Eleven studies that met inclusion criteria were identified. Nine studies were retrospective, and 2 were single-cohort prospective investigations. Of the 9 retrospective studies, 7 reported a goal mean arterial pressure (MAP) of higher than 85 mm Hg. For the 2 prospective studies, the MAP goals were higher than 85 mm Hg and higher than 90 mm Hg. The duration of BP management varied from more than 24 hours to 7 days in 6 of the retrospective studies that reported the duration of treatment. In both prospec...Continue Reading

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Mar 22, 2018·Emergency Medicine Journal : EMJ·Elliott Bertram-Ralph, Daniel Horner
Jan 1, 2020·British Journal of Neurosurgery·Fardad T AfshariAntonino Russo
Aug 1, 2019·Current Neurology and Neuroscience Reports·Michael Karsy, Gregory Hawryluk
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Apr 27, 2021·Neurologic Clinics·Ilyas EliZoher Ghogawala
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Jun 1, 2021·Neurosurgery Clinics of North America·Samira Saadoun, Marios C Papadopoulos
Dec 8, 2021·Minerva anestesiologica·Davide FurlanTiziana Bove

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NCT02232165

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