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Blood pressure and spinal cord injury

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https://www.readbyqxmd.com/read/29470149/chronic-complete-cervical-6-7-cord-transection-distinct-autonomic-and-cardiac-deficits
#1
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
#2
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
#3
Femke Streijger, Kitty So, Neda Manouchehri, Ana Gheorghe, Elena B Okon, Ryan M Chan, Benjamin Ng, Katelyn Shortt, Mypinder Singh 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 pharmacologic 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, PaPO2, hydrostatic pressure, and metabolism within the spinal cord adjacent to the injury site...
January 16, 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
#4
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
#5
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
#6
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
#7
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
#8
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
#9
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
#10
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
https://www.readbyqxmd.com/read/29176992/immunosenescence-in-persons-with-spinal-cord-injury-in-relation-to-urinary-tract-infections-a-cross-sectional-study
#11
David Pavlicek, Jörg Krebs, Simona Capossela, Alessandro Bertolo, Britta Engelhardt, Jürgen Pannek, Jivko Stoyanov
Background: Individuals with a spinal cord injury (SCI), despite specialized rehabilitation and good health care, have a reduced life expectancy. Infectious diseases, such as pneumonias, infected pressure sores and urinary tract infections (UTI) have been identified as the leading causes of mortality. We hypothesise that a premature onset of immune frailty occurs in SCI, possibly caused also by recurrent urinary tract infections.A cross sectional study was performed comparing blood and urine samples between able bodied controls (n = 84) and persons with spinal cord injury (n = 85)...
2017: Immunity & Ageing: I & A
https://www.readbyqxmd.com/read/29163185/orthostatic-intolerance-in-older-persons-etiology-and-countermeasures
#12
REVIEW
Nandu Goswami, Andrew P Blaber, Helmut Hinghofer-Szalkay, Jean-Pierre Montani
Orthostatic challenge produced by upright posture may lead to syncope if the cardiovascular system is unable to maintain adequate brain perfusion. This review outlines orthostatic intolerance related to the aging process, long-term bedrest confinement, drugs, and disease. Aging-associated illness or injury due to falls often leads to hospitalization. Older patients spend up to 83% of hospital admission lying in bed and thus the consequences of bedrest confinement such as physiological deconditioning, functional decline, and orthostatic intolerance represent a central challenge in the care of the vulnerable older population...
2017: Frontiers in Physiology
https://www.readbyqxmd.com/read/29160569/reconstruction-of-bladder-function-and-prevention-of-renal-deterioration-by-means-of-end-to-side-neurorrhaphy-in-rats-with-neurogenic-bladder
#13
Yun Long Li, Jian Jun Wen, Yi Bo Wen, Xiang Fei He, Jun Wei Wu, Yan Wei Li, Zhong Jiang Han, Jin Jin Feng, Shao Hua Yan, Shou Lin Li, John Pfa Heesakkers, Wan Sheng Gao, Jian Guo Wen
AIMS: To investigate the feasibility of restoring bladder function and prevention of renal deterioration by neurorrhaphy in rats with neurogenic bladder (NB). METHODS: Forty-two rats were assigned to the end-to-side nerve coaptation group (ECG, n = 16), no nerve coaptation group (NCG, n = 16), and control group (CG, n = 10). In the ECG, the left ventral root (VR) and dorsal root (DR) of L6 and S1 were transected, and the distal stump of L6VR was sutured to the lateral face of L4VR...
November 21, 2017: Neurourology and Urodynamics
https://www.readbyqxmd.com/read/29160147/impact-of-complete-spinal-cord-injury-on-healing-of-skin-ulcers-in-mouse-models
#14
Suneel Kumar, Martin L Yarmush, Biraja C Dash, Henry C Hsia, Francois Berthiaume
Pressure ulcers (PUs) are common debilitating complications of traumatic spinal cord injury (SCI) and tend to occur in soft tissues around bony prominences. There is, however, little known about the impact of SCI on skin wound healing due to the lack of suitable animal models for studies in controlled experimental settings. Herein we describe a reproducible and clinically relevant mouse model of PUs in the context of complete SCI. Adult male mice (BALB/c) were subjected to thoracic (T9-T10) complete SCI. Immediately after, a skin fold on the back of the mice was lifted and sandwiched between two magnetic discs held in place for 12 hours, thus creating an ischemic area that developed into a PU over the following days...
November 21, 2017: Journal of Neurotrauma
https://www.readbyqxmd.com/read/29142811/carotid-artery-stiffness-and-development-of-hypertension-in-people-with-paraplegia-and-no-overt-cardiovascular-disease-a-7-year-follow-up-study
#15
Olga Vriz, Nicole Bertin, Arianna Ius, Emiliana Bizzarini, Eduardo Bossone, Francesco Antonini-Canterin
Objectives: The aim of this study was to compare arterial stiffness between people with paraplegia and able-bodied persons (ABPs) and to assess cardiovascular markers that may be predictive of the development of arterial hypertension in people with spinal cord injury (SCI). Setting: This study was conducted at rehabilitation Hospital, Udine (Italy). Methods: Fifty-seven patients with SCI were prospectively enrolled and compared with 88 healthy ABPs...
October 2017: Journal of Cardiovascular Echography
https://www.readbyqxmd.com/read/29141501/transient-hypertension-after-spinal-cord-injury-leads-to-cerebrovascular-endothelial-dysfunction-and-fibrosis
#16
Aaron A Phillips, Nusrat Matin, Mengyao Jia, Jordan W Squair, Aaron Monga, Mei Mu Zi Zheng, Rahul Sachdeva, Andrew Yung, Shea Hocolaski, Stacy L Elliott, Piotr Kozlowski, Anne Dorrance, Ismail Laher, Phil Ainslie, Andrei V Krassioukov
We aimed to create a clinically-relevant preclinical model of transient hypertension, and then evaluate the pathophysiological cerebrovascular processes resulting from this novel stimulus, which has recently been epidemiologically linked to cerebrovascular disease. We first developed a clinically-relevant model of transient hypertension, secondary to induced autonomic dysreflexia after spinal cord injury, and demonstrated that in both patients and rats this stimulus leads to drastic acute cerebral hyper-perfusion...
November 15, 2017: Journal of Neurotrauma
https://www.readbyqxmd.com/read/29141498/incidence-and-natural-progression-of-neurogenic-shock-after-traumatic-spinal-cord-injury
#17
Ian A Ruiz, Jordan W Squair, Aaron A Phillips, Christine D Lukac, Dayan Huang, Patrick Oxciano, Dong Yan, Andrei V Krassioukov
Neurogenic shock, a distributive type of circulatory shock after spinal cord injury (SCI), results in profound hypotension. The consequent hemodynamic instability complicates clinical management, delays surgical intervention, and impacts neurological outcome. Moreover, the reported incidence of this condition varies significantly. We establish the true incidence of neurogenic shock by comparing the most common clinical definitions used to diagnose the condition. Further, we characterize the acute progression and recovery of neurogenic shock...
December 18, 2017: Journal of Neurotrauma
https://www.readbyqxmd.com/read/29116946/spinal-cord-injury-by-direct-damage-during-ct-guided-c7-transforaminal-epidural-steroid-injection-a-case-report
#18
Min Cheol Chang
Cervical transforaminal epidural steroid injection (TFESI) under the guidance of computed tomography (CT) can offer great anatomical resolution and precise needle placement in the axial plane. However, some complications, including blood pressure surge, allergic reactions, vasovagal syncope, and cerebral infarct, have been reported after CT-guided cervical TFESI. We report the first case of iatrogenic spinal cord injury (SCI) during a CT-guided cervical TFESI. A 67-year-old woman, upon receiving TFESI on Lt...
November 7, 2017: American Journal of Physical Medicine & Rehabilitation
https://www.readbyqxmd.com/read/29088944/the-impact-of-blood-pressure-management-after-spinal-cord-injury-a-systematic-review-of-the-literature
#19
Yamaan S Saadeh, Brandon W Smith, Jacob R Joseph, Sohaib Y Jaffer, Martin J Buckingham, Mark E Oppenlander, Nicholas J Szerlip, Paul Park
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...
November 2017: Neurosurgical Focus
https://www.readbyqxmd.com/read/29078756/effects-of-lung-protective-mechanical-ventilation-associated-with-permissive-respiratory-acidosis-on-regional-extra-pulmonary-blood-flow-in-experimental-ards
#20
Rudolf Hering, Stefan Kreyer, Christian Putensen
BACKGROUND: Lung protective mechanical ventilation with limited peak inspiratory pressure has been shown to affect cardiac output in patients with ARDS. However, little is known about the impact of lung protective mechanical ventilation on regional perfusion, especially when associated with moderate permissive respiratory acidosis. We hypothesized that lung protective mechanical ventilation with limited peak inspiratory pressure and moderate respiratory acidosis results in an increased cardiac output but unequal distribution of blood flow to the different organs of pigs with oleic-acid induced ARDS...
October 27, 2017: BMC Anesthesiology
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