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Blood pressure and spinal cord injury

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https://www.readbyqxmd.com/read/28447605/traumatic-spinal-cord-injury
#1
REVIEW
Christopher S Ahuja, Jefferson R Wilson, Satoshi Nori, Mark R N Kotter, Claudia Druschel, Armin Curt, Michael G Fehlings
Traumatic spinal cord injury (SCI) has devastating consequences for the physical, social and vocational well-being of patients. The demographic of SCIs is shifting such that an increasing proportion of older individuals are being affected. Pathophysiologically, the initial mechanical trauma (the primary injury) permeabilizes neurons and glia and initiates a secondary injury cascade that leads to progressive cell death and spinal cord damage over the subsequent weeks. Over time, the lesion remodels and is composed of cystic cavitations and a glial scar, both of which potently inhibit regeneration...
April 27, 2017: Nature Reviews. Disease Primers
https://www.readbyqxmd.com/read/28447274/classification-and-regression-tree-model-for-predicting-tracheostomy-in-patients-with-traumatic-cervical-spinal-cord-injury
#2
Dae-Sang Lee, Chi-Min Park, Keumhee Chough Carriere, Joonghyun Ahn
PURPOSE: In patients with cervical spinal cord injury (CSCI), respiratory compromise and the need for tracheostomy are common. The purpose of this study was to identify common risk factors for tracheostomy following traumatic CSCI and develop a decision tree for tracheostomy in traumatic CSCI patients without pulmonary function test. METHODS: Data of 105 trauma patients with CSCI admitted in our institution from April, 2008 to February, 2014 were retrospectively analyzed...
April 26, 2017: European Spine Journal
https://www.readbyqxmd.com/read/28416148/alterations-in-autonomic-cerebrovascular-control-after-spinal-cord-injury
#3
Dong-Il Kim, Can Ozan Tan
Among chronic cardiovascular and metabolic sequelae of spinal cord injury (SCI) is an up-to four-fold increase in the risk of ischemic and hemorrhagic stroke, suggesting that individuals with SCI cannot maintain stable cerebral perfusion. In able-bodied individuals, the cerebral vasculature is able to regulate cerebral perfusion in response to swings in arterial pressure (cerebral autoregulation), blood gases (cerebral vasoreactivity), and neural metabolic demand (neurovascular coupling). This ability depends, at least partly, on intact autonomic function, but high thoracic and cervical spinal cord injuries result in disruption of sympathetic and parasympathetic cerebrovascular control...
April 4, 2017: Autonomic Neuroscience: Basic & Clinical
https://www.readbyqxmd.com/read/28351230/continuous-monitoring-and-visualization-of-optimum-spinal-cord-perfusion-pressure-in-patients-with-acute-cord-injury
#4
Suliang Chen, Peter Smieleweski, Marek Czosnyka, Marios C Papadopoulos, Samira Saadoun
The optimum spinal cord perfusion pressure (SCPP) after traumatic spinal cord injury (TSCI) is unknown. Here, we describe techniques to compute and display the optimum SCPP in real-time. We recruited adults within 72 hours of severe TSCI (ASIA grades A-C). A pressure probe and a microdialysis catheter were placed on the injured cord. SCPP was computed as mean arterial pressure (MAP) minus intraspinal pressure (ISP), spinal pressure reactivity index (sPRx) as the running ISP/MAP correlation coefficient and continuous optimum SCPP (cSCPPopt) as the SCPP that minimizes sPRx in a moving four-hour window...
March 29, 2017: Journal of Neurotrauma
https://www.readbyqxmd.com/read/28350947/traumatic-spinal-cord-injury-repair-and-regeneration
#5
Christopher S Ahuja, Satoshi Nori, Lindsay Tetreault, Jefferson Wilson, Brian Kwon, James Harrop, David Choi, Michael G Fehlings
BACKGROUND: Traumatic spinal cord injuries (SCI) have devastating consequences for the physical, financial, and psychosocial well-being of patients and their caregivers. Expediently delivering interventions during the early postinjury period can have a tremendous impact on long-term functional recovery. PATHOPHYSIOLOGY: This is largely due to the unique pathophysiology of SCI where the initial traumatic insult (primary injury) is followed by a progressive secondary injury cascade characterized by ischemia, proapoptotic signaling, and peripheral inflammatory cell infiltration...
March 1, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28336819/fundamental-hemodynamic-mechanisms-mediating-the-response-to-myocardial-ischemia-in-conscious-paraplegic-mice-cardiac-output-versus-peripheral-resistance
#6
Heidi L Lujan, Stephen E DiCarlo
Autonomic dysfunction, a relative sedentary lifestyle, a reduced muscle mass and increased adiposity leads to metabolic abnormalities that accelerate the development of coronary artery disease (CAD) in individuals living with spinal cord injury (SCI). An untoward cardiac incident is related to the degree of CAD, suggesting that the occurrence of a significant cardiac event is significantly higher for individuals with SCI Thus, understanding the fundamental hemodynamic mechanisms mediating the response to myocardial ischemia has the potential to positively impact individuals and families living with SCI Accordingly, we systematically investigated if thoracic level 5 spinal cord transection (T5X; paraplegia) alters the arterial blood pressure response to coronary artery occlusion and if the different arterial blood pressure responses to coronary artery occlusion between intact and paraplegic mice are mediated by changes in cardiac output and or systemic peripheral resistance and whether differences in cardiac output are caused by changes in heart rate and or stroke volume...
March 2017: Physiological Reports
https://www.readbyqxmd.com/read/28291783/oesophageal-heat-exchangers-with-a-diameter-of-11mm-or-14-7mm-are-equally-effective-and-safe-for-targeted-temperature-management
#7
Daniel C Schroeder, Maria Guschlbauer, Alexandra C Maul, Daniel A Cremer, Ingrid Becker, David de la Puente Bethencourt, Peter Paal, Stephan A Padosch, Wolfgang A Wetsch, Thorsten Annecke, Bernd W Böttiger, Anja Sterner-Kock, Holger Herff
BACKGROUND: Targeted temperature management (TTM) is widely used in critical care settings for conditions including hepatic encephalopathy, hypoxic ischemic encephalopathy, meningitis, myocardial infarction, paediatric cardiac arrest, spinal cord injury, traumatic brain injury, ischemic stroke and sepsis. Furthermore, TTM is a key treatment for patients after out-of-hospital cardiac-arrest (OHCA). However, the optimal cooling method, which is quick, safe and cost-effective still remains controversial...
2017: PloS One
https://www.readbyqxmd.com/read/28289632/hemodynamic-adaptations-to-regular-exercise-in-people-with-spinal-cord-injury
#8
Young Hee Lee, Jin Hyeong Lee, Sung Hoon Kim, Dongsoo Yi, Kyung Joon Oh, Ji Hyun Kim, Tae Jun Park, Hanul Kim, Jae Seung Chang, In Deok Kong
OBJECTIVE: To investigate the real-time cardiovascular response to the progressive overload exercise in different levels of spinal cord injury (SCI), and to find out whether regular exercise has effect on these cardiovascular responses. METHODS: The study enrolled 8 able-bodied individuals in the control group plus 15 SCI subjects who were divided into two groups by their neurological level of injury: high-level SCI group (T6 or above) and low-level SCI group (T7 or below)...
February 2017: Annals of Rehabilitation Medicine
https://www.readbyqxmd.com/read/28286201/arm-cranking-exercise-training-reduces-plasminogen-activator-inhibitor-1-in-people-with-spinal-cord-injury
#9
Masahiro Horiuchi, Koichi Okita
OBJECTIVE: To investigate the effects of arm-cranking exercise training on plasminogen activator inhibitor 1 (PAI-1) as a risk factor of deep vein thrombosis, along with general physical parameters such as, muscle strength, aerobic capacity, and hemodynamics, in individuals with spinal cord injury (SCI) and control. DESIGN: Longitudinal study. INTERVENTION: Community-based supervised intervention. PARTICIPANTS: Nine individuals with SCI volunteered for this study...
March 9, 2017: Archives of Physical Medicine and Rehabilitation
https://www.readbyqxmd.com/read/28228335/alterations-in-cardiac-autonomic-control-in-spinal-cord-injury
#10
REVIEW
Fin Biering-Sørensen, Tor Biering-Sørensen, Nan Liu, Lasse Malmqvist, Jill Maria Wecht, Andrei Krassioukov
A spinal cord injury (SCI) interferes with the autonomic nervous system (ANS). The effect on the cardiovascular system will depend on the extent of damage to the spinal/central component of ANS. The cardiac changes are caused by loss of supraspinal sympathetic control and relatively increased parasympathetic cardiac control. Decreases in sympathetic activity result in heart rate and the arterial blood pressure changes, and may cause arrhythmias, in particular bradycardia, with the risk of cardiac arrest in those with cervical or high thoracic injuries...
February 15, 2017: Autonomic Neuroscience: Basic & Clinical
https://www.readbyqxmd.com/read/28174025/effects-of-liposome-based-local-suppression-of-nerve-growth-factor-in-the-bladder-on-autonomic-dysreflexia-during-urinary-bladder-distention-in-rats-with-spinal-cord-injury
#11
Katsumi Kadekawa, Tsuyoshi Yoshizawa, Naoki Wada, Takahiro Shimizu, Tsuyoshi Majima, Pradeep Tyagi, William C de Groat, Kimio Sugaya, Naoki Yoshimura
PURPOSE: To examine (1) whether spinal cord injury (SCI) time-dependently increases the severity of autonomic dysreflexia (AD) and expression levels of bladder nerve growth factor (NGF) protein, and (2) whether local suppression of NGF in the bladder improves SCI-induced AD in rats. MATERIALS AND METHODS: SCI was produced by the transection of the T2/3 spinal cord in female Sprague-Dawley rats. At 4 or 8weeks after SCI, differences in the mean arterial blood pressure (ΔMAP) and heart rate (ΔMHR) during graded increases in intravesical pressure to 20, 40 and 60cm H2O from those before bladder distention and NGF protein levels in the bladder wall were evaluated in spinal intact and SCI rats under urethane anesthesia...
February 4, 2017: Experimental Neurology
https://www.readbyqxmd.com/read/28165305/effect-of-anesthesia-associated-hypotension-on-neurologic-outcome-in-dogs-undergoing-hemilaminectomy-because-of-acute-severe-thoracolumbar-intervertebral-disk-herniation-56-cases-2007-2013
#12
Alexandra Dixon, Amy E Fauber
OBJECTIVE To evaluate the effect of anesthesia-associated hypotension on final motor and urinary function in paraplegic dogs without nociception that underwent hemilaminectomy because of acute, severe thoracolumbar intervertebral disk herniation (IVDH). DESIGN Retrospective case series. ANIMALS 56 paraplegic dogs with acute thoracolumbar IVDH and absent nociception. PROCEDURES Medical records were reviewed, and signalment, history, anesthetic details, and results of serial neurologic assessments performed for at least 4 weeks after surgery were recorded...
February 15, 2017: Journal of the American Veterinary Medical Association
https://www.readbyqxmd.com/read/28117618/association-between-abnormal-arterial-stiffness-and-cardiovascular-risk-factors-in-people-with-chronic-spinal-cord-injury
#13
Masae Miyatani, S Mohammad Alavinia, Maggie Szeto, Cameron Moore, B Catharine Craven
Aims To describe the association between cardiovascular risk factors and abnormal arterial stiffness, defined by a carotid-femoral pulse wave velocity ≥ 10 m/s, in patients with chronic spinal cord injury (SCI). Methods Ninety consenting adults with chronic SCI (C1-T10 ASIA Impairment Scale A-D) participated in this cross-sectional study. The cardiovascular risk factors considered included age, sex, duration of injury, neurological level of injury (C1-T1, tetraplegia; T2-T12, paraplegia), age at injury, impairment scale category, supine resting systolic blood pressure, diastolic blood pressure, mean arterial pressure, heart rate, leisure time physical activity, treated hypertension, treated hyperlipidemia, diabetes, lipid profiles, fasting blood glucose, glycated hemoglobin, and C reactive protein...
January 1, 2017: European Journal of Preventive Cardiology
https://www.readbyqxmd.com/read/28114866/refractory-orthostatic-hypotension-in-a-patient-with-a-spinal-cord-injury-treatment-with-droxidopa
#14
Eva Canosa-Hermida, Cristina Mondelo-García, María Elena Ferreiro-Velasco, Sebastián Salvador-de la Barrera, Antonio Montoto-Marqués, Antonio Rodríguez-Sotillo, José Ramón Vizoso-Hermida
CONTEXT: Orthostatic hypotension (OH) is a common complication in patients with a spinal cord injury, mainly affecting complete injuries above neurological level T6. It is generally more severe during the acute phase but can remain symptomatic for several years. FINDINGS: A 65-year-old male with a grade ASIA A post-traumatic cervical spinal cord injury, at neurological level C4, presenting with symptomatic refractory OH. Increased blood pressure (BP) levels and an overall clinical improvement was observed after administering an increasing dose of droxidopa...
January 24, 2017: Journal of Spinal Cord Medicine
https://www.readbyqxmd.com/read/28112598/acute-effects-of-glossopharyngeal-insufflation-in-people-with-cervical-spinal-cord-injury
#15
Malin Nygren-Bonnier, Tomas A Schiffer, Peter Lindholm
OBJECTIVES: To evaluate acute effects of glossopharyngeal insufflation (GI) on lung function, airway pressure (Paw), blood pressure and heart rate (HR) in people with cervical spinal cord injury (CSCI). DESIGN: Case-control design. SETTING: Karolinska Institutet, Stockholm, Sweden. PARTICIPANTS: Ten participants with CSCI suffering from lesions between C4 and C8, and ASIA classification of A or B were recruited. Ten healthy particpants familiar with GI were recruited as a reference group...
January 23, 2017: Journal of Spinal Cord Medicine
https://www.readbyqxmd.com/read/28075489/cough-augmentation-techniques-for-extubation-or-weaning-critically-ill-patients-from-mechanical-ventilation
#16
REVIEW
Louise Rose, Neill Kj Adhikari, David Leasa, Dean A Fergusson, Douglas McKim
BACKGROUND: There are various reasons why weaning and extubation failure occur, but ineffective cough and secretion retention can play a significant role. Cough augmentation techniques, such as lung volume recruitment or manually- and mechanically-assisted cough, are used to prevent and manage respiratory complications associated with chronic conditions, particularly neuromuscular disease, and may improve short- and long-term outcomes for people with acute respiratory failure. However, the role of cough augmentation to facilitate extubation and prevent post-extubation respiratory failure is unclear...
January 11, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28018240/distinctive-steady-state-heart-rate-and-blood-pressure-responses-to-passive-robotic-leg-exercise-and-functional-electrical-stimulation-during-head-up-tilt
#17
Amirehsan Sarabadani Tafreshi, Robert Riener, Verena Klamroth-Marganska
Introduction: Tilt tables enable early mobilization of patients by providing verticalization. But there is a high risk of orthostatic hypotension provoked by verticalization, especially after neurological diseases such as spinal cord injury. Robot-assisted tilt tables might be an alternative as they add passive robotic leg exercise (PE) that can be enhanced with functional electrical stimulation (FES) to the verticalization, thus reducing the risk of orthostatic hypotension. We hypothesized that the influence of PE on the cardiovascular system during verticalization (i...
2016: Frontiers in Physiology
https://www.readbyqxmd.com/read/28008298/severe-protracted-spasm-of-urinary-bladder-and-autonomic-dysreflexia-caused-by-changing-the-suprapubic-catheter-in-a-cervical-spinal-cord-injury-patient-treatment-by-a-bolus-dose-and-increased-total-daily-dose-of-intrathecal-baclofen
#18
Subramanian Vaidyanathan, Tun Oo, Bakul M Soni, Peter L Hughes, Gurpreet Singh
BACKGROUND: Intrathecal administration of baclofen by implanted pump reduces rigidity and muscle spasms. Its use specifically to control bladder spasms has not been reported. CASE REPORT: A tetraplegic patient developed severe, protracted, bladder spasms, abdominal muscles spasms, and high blood pressure after change of suprapubic catheter; nifedipine, diazepam, and paracetamol did not control spasms; bolus dose of baclofen intrathecally produced prompt relief via baclofen pump...
2016: Clinical Medicine Insights. Case Reports
https://www.readbyqxmd.com/read/28004433/effects-of-early-and-delayed-initiation-of-exercise-training-on-cardiac-and-haemodynamic-function-after-spinal-cord-injury
#19
David W Popok, Christopher R West, Laura McCracken, Andrei V Krassioukov
What is the central question of this study? How does early versus delayed initiation of passive hindlimb cycling, as well as detraining, affect cardiac function and blood pressure control in a rodent model of spinal cord injury? What is the main finding and its importance? Early or delayed initiation of hindlimb cycling improves cardiac and haemodynamic function in spinal cord injury, although the benefits of early administration are more pronounced. We also demonstrate the need for exercise to be maintained, because detraining rapidly reverses the cardiac and haemodynamic benefits...
February 1, 2017: Experimental Physiology
https://www.readbyqxmd.com/read/27998205/2015-parapan-american-games-autonomic-function-but-not-physical-activity-is-associated-with-vascular-cognitive-impairment-in-spinal-cord-injury
#20
Aaron A Phillips, Jordan R Squair, Katharine D Currie, Yu-Chieh Tzeng, Philip N Ainslie, Andrei V Krassioukov
Autonomic dysfunction and diminished capacity for physical exercise are commonly implicated in the 3- to 4-fold increased risk of cerebrovascular disease after spinal cord injury (SCI). We assessed cerebrovascular function (transcranial Doppler; neurovascular coupling [NVC], and cerebral pressure-flow regulation) in elite national level wheelchair rugby players (n = 23), normally active SCI individuals (n = 12), and able-bodied controls (n = 13). Cognitive (Stroop test) and autonomic function (postural change) also were evaluated...
March 15, 2017: Journal of Neurotrauma
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