Hemodynamic parameters and timing of surgical decompression in acute cervical spinal cord injury.
作者： Sagun Tuli , Jayshree Tuli , William P. Coleman , Fred H. Geisler , Andrei Krassioukov
DOI: 10.1080/10790268.2007.11754582
关键词: Neurogenic shock 、 Randomization 、 Blood pressure 、 Randomized controlled trial 、 Anesthesia 、 Cervical vertebrae 、 Hemodynamics 、 Shock (circulatory) 、 Heart rate 、 Medicine
摘要: Background/objectives To evaluate the relationship between severity of cervical spinal cord injury (SCI) (American Spinal Injury Association [ASIA] grade), presence neurogenic shock, and timing surgical intervention. This is a post-hoc analysis from Sygen multicenter randomized controlled trial. Methods Blood pressure (BP) heart rate (HR) data were collected when patients first assessed in emergency room (Time A) at time randomization B). Individuals subdivided by ASIA grade level systolic BP (SBP). Results Only individuals with SCI trial (n = 577) evaluated. Severe complete (ASIA was established 57% these patients. A total 74 (13%) shock (SBP or 90 mmHg (P 0.025). Multivariable after adjusting for confounders revealed statistically significant difference to intervention based on SBP 0.026), yet not B C/D. Conclusions The associated delay SCI. Detailed evaluation autonomic dysfunctions following including cardiovascular instability could improve our understanding complexities clinical presentations possible neurological outcomes.
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