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Blood pressure and spinal cord injury

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https://www.readbyqxmd.com/read/29683363/cardiovascular-autonomic-response-to-orthostatic-stress-under-hypoxia-in-patients-with-spinal-cord-injury
#1
Shu-Chun Huang, Kuo-Cheng Liu, Alice M K Wong, Shih-Chieh Chang, Jong-Shyan Wang
Huang, Shu-Chun, Kuo-Cheng Liu, Alice M.K. Wong, Shih-Chieh Chang, and Jong-Shyan Wang. Cardiovascular autonomic response to orthostatic stress under hypoxia in patients with spinal cord injury. High Alt Med Biol. 00:000-000, 2018. AIMS: Determining whether systemic hypoxia aggravates the severity of autonomic cardiovascular dysfunction in orthostatic stress among patients with spinal cord injuries (SCIs). METHODS: Twenty-four male patients with chronic SCI whose neurological levels were above T6 were recruited...
April 23, 2018: High Altitude Medicine & Biology
https://www.readbyqxmd.com/read/29668610/a-term-vaginal-delivery-by-a-patient-with-traumatic-tetraplegia-a-case-report
#2
Changfang Yao, Yongjuan Xu, Li Dai, Yan Lv, Xiaoli Xu, Wenfeng Ye
RATIONALE: About 60,0000 people are involved in traffic accident each year in China and spinal cord injury (SCI) often occurs. Pregnant women with paraplegia is rare, and they face higher risk during pregnancy and childbirth. PATIENT CONCERNS: We report a case of a 35-year-old patient with SCI, who had vaginal forceps delivery at 38 weeks and 5 days of gestation. DIAGNOSES: The patient was diagnosed with term pregnancy with traumatic tetraplegia...
April 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29619250/relationship-between-autonomic-cardiovascular-control-and-obstructive-sleep-apnoea-in-persons-with-spinal-cord-injury-a-retrospective-study
#3
Xizhe Fang, Min Yin Goh, Christopher O'Callaghan, David Berlowitz
Study design: Retrospective study. Objective: To determine if there is an association between obstructive sleep apnoea (OSA) and blood pressure (BP) pattern or heart rate variability (HRV) in people with spinal cord injury (SCI). Setting: A state-based spinal cord service in Victoria, Australia. Methods: We identified 42 subjects who had ambulatory BP monitoring (ABPM) within 6 months of a diagnostic sleep study at Austin Hospital between 2009 and 2014...
2018: Spinal Cord Series and Cases
https://www.readbyqxmd.com/read/29600896/wavelet-decomposition-analysis-is-a-clinically-relevant-strategy-to-evaluate-cerebrovascular-buffering-of-blood-pressure-after-spinal-cord-injury
#4
Saqib Saleem, Diana Vucina, Zoe Sarafis, Amanda H X Lee, Jordan W Squair, Otto F Barak, Geoff B Coombs, Tanja Mijacika, Andrei V Krassioukov, Philip N Ainslie, Zeljko Dujic, Yu-Chieh Tzeng, Aaron A Phillips
The capacity of cerebrovasculature to buffer changes in blood pressure (BP) is crucial to prevent stroke, the incidence of which is 3-4 fold elevated after spinal cord injury (SCI). Disruption of descending sympathetic pathways within the spinal cord due to cervical SCI may result in impaired cerebrovascular buffering. Only linear analyses of cerebrovascular buffering of BP, such as transfer function, have been utilized in SCI research. This approach does not account for inherent non-linearity and non-stationarity components of cerebrovascular regulation, often depends on perturbations of BP to increase the statistical power, and does not account for influence of arterial CO2 tension...
March 30, 2018: American Journal of Physiology. Heart and Circulatory Physiology
https://www.readbyqxmd.com/read/29595874/temporal-analysis-of-cardiovascular-control-and-function-following-incomplete-t3-and-t10-spinal-cord-injury-in-rodents
#5
Kathryn A Harman, Gregory States, Abigail Wade, Chad Stepp, Grace Wainwright, Kathryn DeVeau, Nicholas King, Alice Shum-Siu, David S K Magnuson
Spinal cord injury (SCI) is a devastating condition that results in whole-body dysfunction, notably cardiovascular (CV) disruption and disease. Injury-induced destruction of autonomic pathways in conjunction with a progressive decline in physical fitness contribute to the poor CV status of SCI individuals. Despite the wide use of exercise training as a therapeutic option to reduce CV dysfunction, little is known about the acute hemodynamic responses to the exercise itself. We investigated CV responses to an exercise challenge (swimming) following both high and low thoracic contusion to determine if the CV system is able to respond appropriately to the challenge of swimming...
March 2018: Physiological Reports
https://www.readbyqxmd.com/read/29568266/normalization-of-blood-pressure-with-spinal-cord-epidural-stimulation-after-severe-spinal-cord-injury
#6
Susan J Harkema, Siqi Wang, Claudia A Angeli, Yangsheng Chen, Maxwell Boakye, Beatrice Ugiliweneza, Glenn A Hirsch
Chronic low blood pressure and orthostatic hypotension remain challenging clinical issues after severe spinal cord injury (SCI), affecting health, rehabilitation, and quality of life. We previously reported that targeted lumbosacral spinal cord epidural stimulation (scES) could promote stand and step functions and restore voluntary movement in patients with chronic motor complete SCI. This study addresses the effects of targeted scES for cardiovascular function (CV-scES) in individuals with severe SCI who suffer from chronic hypotension...
2018: Frontiers in Human Neuroscience
https://www.readbyqxmd.com/read/29563843/fatal-cerebral-hemorrhage-in-a-tetraplegic-patient-due-to-autonomic-dysreflexia-triggered-by-delay-in-emptying-urinary-bladder-after-unsuccessful-intermittent-catheterization-by-carer-lessons-learned
#7
Subramanian Vaidyanathan, Bakulesh M Soni, Peter L Hughes, Tun Oo
Introduction: Over-distension of urinary bladder in a high spinal cord injury patient is a triggering factor for autonomic dysreflexia. Removing triggering factors is vital to prevent autonomic dysreflexia. Case presentation: A 36-year-old tetraplegic patient, who was managed by intermittent catheterizations performed by caregivers, developed recurrent autonomic dysreflexia during a week due to: 1) carers not performing intermittent catheterizations every night; 2) infrequent catheterizations during the day, leading to distension of urinary bladder...
2018: International Medical Case Reports Journal
https://www.readbyqxmd.com/read/29559542/bet-1-can-induced-hypertension-improve-outcome-following-acute-traumatic-spinal-cord-injury
#8
Elliott Bertram-Ralph, Daniel Horner
A shortcut review was carried out to establish whether augmentation of blood pressure to a high mean arterial pressure (MAP) target in the early phase of traumatic spinal cord injury (SCI) could lead to improvements in morbidity or mortality. 23 directly relevant papers were found using the reported search strategy. Of these, two systematic reviews collated the best evidence to answer the clinical question. The author, date and country of publication; patient group studied; study type; relevant outcomes; results and study weaknesses of the best papers are tabulated...
April 2018: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/29541489/cerebrospinal-fluid-drains-reduce-risk-of-spinal-cord-injury-for-thoracic-thoracoabdominal-aneurysm-surgery-a-review
#9
REVIEW
Nancy E Epstein
Background: The risk of spinal cord injury (SCI) due to decreased cord perfusion following thoracic/thoracoabdominal aneurysm surgery (T/TL-AAA) and thoracic endovascular aneurysm repair (TEVAR) ranges up to 20%. For decades, therefore, many vascular surgeons have utilized cerebrospinal fluid drainage (CSFD) to decrease intraspinal pressure and increase blood flow to the spinal cord, thus reducing the risk of SCI/ischemia. Methods: Multiple studies previously recommend utilizing CSFD following T/TL-AAA/TEVAR surgery to treat SCI by increasing spinal cord blood flow...
2018: Surgical Neurology International
https://www.readbyqxmd.com/read/29500404/comparison-of-diurnal-blood-pressure-and-urine-production-between-people-with-and-without-chronic-spinal-cord-injury
#10
Min Yin Goh, Melinda S Millard, Edmund C K Wong, David J Berlowitz, Marnie Graco, Rachel M Schembri, Douglas J Brown, Albert G Frauman, Christopher J O'Callaghan
STUDY DESIGN: Observational study. OBJECTIVES: To quantify diurnal blood pressure (BP) patterns and nocturnal hypertension and to measure diurnal urine production in people with chronic spinal cord injury (SCI), compared with controls without SCI. SETTING: Chronic SCI population in the community in Victoria, Australia. METHODS: Participants were recruited by advertisement, and sustained SCI at least a year prior or were healthy able-bodied volunteers...
March 2, 2018: Spinal Cord
https://www.readbyqxmd.com/read/29470149/chronic-complete-cervical-6-7-cord-transection-distinct-autonomic-and-cardiac-deficits
#11
Heidi L Lujan, Anne Tonson, Robert W Wiseman, Stephen E DiCarlo
Spinal cord injury (SCI) resulting in tetraplegia is a devastating, life-changing insult causing paralysis and sensory impairment as well as distinct autonomic dysfunction that triggers compromised cardiovascular, bowel, bladder and sexual activity. Life becomes a battle for independence as even routine bodily functions and the smallest activity of daily living become a major challenge. Accordingly, there is a critical need for a chronic pre-clinical model of tetraplegia. This report addresses this critical need by comparing, for the first time, resting, reflex and stress-induced cardiovascular, autonomic and hormonal responses each week for 4 weeks in 12 sham-operated intact rats and 12 rats with chronic, complete C6-7 spinal cord transection...
February 22, 2018: Journal of Applied Physiology
https://www.readbyqxmd.com/read/29415014/buttock-tissue-response-to-loading-in-men-with-spinal-cord-injury
#12
Sharon Eve Sonenblum, Stephen H Sprigle
OBJECTIVE/BACKGROUND: Despite the fact that most people with a spinal cord injury who use a wheelchair for mobility are considered at-risk for pressure ulcer (PrU) development, there still exists a spectrum of risk amongst this group. Efforts to differentiate risk level would benefit from clinical tools that can measure or predict the buttocks response to loading. Therefore, the goal of this study was to identify how tissue compliance and blood flow were impacted by clinically-measurable risk factors in young men with SCI...
2018: PloS One
https://www.readbyqxmd.com/read/29338544/a-direct-comparison-between-norepinephrine-and-phenylephrine-for-augmenting-spinal-cord-perfusion-in-a-porcine-model-of-spinal-cord-injury
#13
Femke Streijger, Kitty So, Neda Manouchehri, Ana Gheorghe, Elena B Okon, Ryan M Chan, Benjamin Ng, Katelyn Shortt, Mypinder S Sekhon, Donald E Griesdale, Brian K Kwon
Current clinical guidelines recommend elevating the mean arterial blood pressure (MAP) to increase spinal cord perfusion in patients with acute spinal cord injury (SCI). This is typically achieved with vasopressors such as norepinephrine (NE) and phenylephrine (PE). These drugs differ in their pharmacological properties and potentially have different effects on spinal cord blood flow (SCBF), oxygenation (PO2 ), and downstream metabolism after injury. Using a porcine model of thoracic SCI, we evaluated how these vasopressors influenced intraparenchymal SCBF, PO2 , hydrostatic pressure, and metabolism within the spinal cord adjacent to the injury site...
March 28, 2018: Journal of Neurotrauma
https://www.readbyqxmd.com/read/29330514/a-comparison-of-static-and-dynamic-cerebral-autoregulation-during-mild-whole-body-cold-stress-in-individuals-with-and-without-cervical-spinal-cord-injury-a-pilot-study
#14
Jan W van der Scheer, Yoshi-Ichiro Kamijo, Christof A Leicht, Philip J Millar, Manabu Shibasaki, Victoria L Goosey-Tolfrey, Fumihiro Tajima
STUDY DESIGN: Experimental study. OBJECTIVES: To characterize static and dynamic cerebral autoregulation (CA) of individuals with cervical spinal cord injury (SCI) compared to able-bodied controls in response to moderate increases in mean arterial pressure (MAP) caused by mild whole-body cold stress. SETTING: Japan METHODS: Five men with complete autonomic cervical SCI (sustained > 5 y) and six age-matched able-bodied men participated in hemodynamic, temperature, catecholamine and respiratory measurements for 60 min during three consecutive stages: baseline (10 min; 33 °C water through a thin-tubed whole-body suit), mild cold stress (20 min; 25 °C water), and post-cold recovery (30 min; 33 °C water)...
January 12, 2018: Spinal Cord
https://www.readbyqxmd.com/read/29323399/-usability-and-acceptability-of-portable-exoskeletons-for-gait-training-in-subjects-with-spinal-cord-injury-a-systematic-review
#15
H Mardomingo-Medialdea, P Fernandez-Gonzalez, F Molina-Rueda
INTRODUCTION: Spinal cord injury limits severely life expectancy and it causes in a restriction in the activities of the daily life of the subjects who suffer it. Training the gait with portable exoskeletons in subjects with spinal cord injury is a new approach to rehabilitation. AIM: To examine the usability and acceptability of these devices for gait training in subjects with spinal cord injury. PATIENTS AND METHODS: A literature search was conducted until February 2017 in the databases: Medline (PubMed, EBSCO), PEDro, Scopus and Web of Science...
January 16, 2018: Revista de Neurologia
https://www.readbyqxmd.com/read/29284796/intermittent-negative-pressure-applied-to-the-lower-limb-increases-foot-macrocirculatory-and-microcirculatory-blood-flow-pulsatility-in-people-with-spinal-cord-injury
#16
Øyvind Heiberg Sundby, Lars Øivind Høiseth, Ingebjørg Irgens, Iacob Mathiesen, Eivind Lundgaard, Hanne Haugland, Harald Weedon-Fekjær, Jon O Sundhagen, Gunnar Sanbæk, Jonny Hisdal
STUDY DESIGN: Experimental prestudy and poststudy. OBJECTIVES: Examine the acute effects of intermittent negative pressure (INP) applied to the lower limb on foot circulation in people with spinal cord injuries (SCIs). SETTING: Vascular laboratory, Oslo University Hospital. METHODS: Twenty-four people with SCI (median age 59 years, range 29-74) were exposed to lower leg INP (-40 mm Hg) using an air-tight pressure chamber connected to an INP generator...
December 28, 2017: Spinal Cord
https://www.readbyqxmd.com/read/29259348/cold-pressor-test-in-spinal-cord-injury-revisited
#17
REVIEW
Michèle Hubli, Doris Bolt, Andrei V Krassioukov
STUDY DESIGN: Systematic review. OBJECTIVES: A spinal cord injury (SCI) commonly results in alterations of cardiovascular physiology. In order to investigate such alterations, the cold pressor test (CPT) has been used as an established challenge test. This review summarizes the basic physiology underlying a CPT, discusses potential mechanisms responsible for abnormal pressor responses following SCI, and highlights the utility of CPT in the SCI population. SETTING: Canada and Switzerland...
December 20, 2017: Spinal Cord
https://www.readbyqxmd.com/read/29226126/prevalence-of-autonomic-dysreflexia-in-patients-with-spinal-cord-injury-above-t6
#18
Eun Sun Lee, Min Cheol Joo
Objective: To investigate the prevalence of autonomic dysreflexia (AD) using ambulatory blood pressure monitoring (ABPM) and the autonomic dysfunction following spinal cord injury (ADFSCI) questionnaire in patients with spinal cord injury (SCI) above T6. Methods: Twenty-eight patients diagnosed with SCI above T6 were enrolled. ABPM and ADFSCI were utilized to assess AD. Using ABPM, systolic blood pressure (SBP), diastolic blood pressure, and heart rate (HR) were measured at 30-minute intervals...
2017: BioMed Research International
https://www.readbyqxmd.com/read/29205090/rapamycin-exacerbates-cardiovascular-dysfunction-after-complete-high-thoracic-spinal-cord-injury
#19
Khalid C Eldahan, David H Cox, Jenna L Gollihue, Samir P Patel, Alexander G Rabchevsky
Autonomic dysreflexia (AD) is a potentially life-threatening syndrome in individuals with spinal cord injury (SCI) above the T6 spinal level that is characterized by episodic hypertension in response to noxious stimuli below the lesion. Maladaptive intraspinal plasticity is thought to contribute to the temporal development of AD, and experimental approaches that reduce such plasticity mitigate the severity of AD. The mammalian target of rapamycin (mTOR) has gained interest as a mediator of plasticity, regeneration and nociceptor hypersensitivity in the injured spinal cord...
December 5, 2017: Journal of Neurotrauma
https://www.readbyqxmd.com/read/29200479/management-of-sub-axial-cervical-spine-injuries
#20
Gautam Zaveri, Gurdip Das
Sub-axial cervical spine injuries are commonly seen in patients with blunt trauma. They may be associated with spinal cord injury resulting in tetraplegia and severe permanent disability. Immobilization of the neck, maintenance of blood pressure and oxygenation, rapid clinical and radiological assessment of all injuries, and realignment of the spinal column are the key steps in the emergency management of these injuries. The role of intravenous methylprednisolone administration in acute spinal cord injuries remains controversial...
November 2017: Indian Journal of Orthopaedics
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