scholarly journals THE IMPACT AND EVOLUTION OF ACUTE SPINAL CORD INJURY ON AUTONOMIC CARDIOVASCULAR CONTROL AND SUSCEPTIBILITY TO CARDIAC ARRHYTHMIA

2017 ◽  
Vol 33 (10) ◽  
pp. S156-S157
Author(s):  
V. Lucci ◽  
J. Inskip ◽  
O. Sandberg ◽  
S. Bajaj ◽  
I. Ruiz-Romero ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Cardiac Arrhythmia ◽  
Cardiovascular Control ◽  
Acute Spinal Cord Injury ◽  
Cord Injury ◽  
Autonomic Cardiovascular Control ◽  
The Impact

scholarly journals Timing of Decompression in Patients With Acute Spinal Cord Injury: A Systematic Review

2017 ◽  
Vol 7 (3_suppl) ◽  
pp. 95S-115S ◽  
Author(s):  
Jefferson R. Wilson ◽  
Lindsay A. Tetreault ◽  
Brian K. Kwon ◽  
Paul M. Arnold ◽  
Thomas E. Mroz ◽  
...  
Keyword(s):  
Systematic Review ◽  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Surgical Decompression ◽  
Acute Spinal Cord Injury ◽  
Strength Of Evidence ◽  
Cord Injury ◽  
Central Cord Syndrome ◽  
Low Strength ◽  
The Impact

Study Design: Systematic review. Objective: To conduct a systematic review and synthesis of the literature to assess the comparative effectiveness, safety, and cost-effectiveness of early (≤24 hours) versus late decompression (>24 hours) in adults with acute spinal cord injury (SCI). Methods: A systematic search was conducted of Medline, EMBASE, the Cochrane Collaboration Library, and Google Scholar to identify studies published through November 6, 2014. Studies published in any language, in humans, and with an abstract were considered for inclusion. Included studies were critically appraised and the overall strength of evidence was determined using methods proposed by the Grading of Recommendation Assessment, Development and Evaluation working group. Results: The search yielded 449 potentially relevant citations. Sixteen additional primary studies were identified through other sources. Six studies met inclusion criteria. All but 2 studies were considered to have moderately high risk of bias. Across studies and injury levels, the impact of early surgical decompression (≤24 hours) on clinically important improvement in neurological status was variable. Isolated studies reported statistically significant and clinically important improvements at 6 months (cervical injury, low strength of evidence) and following discharge from inpatient rehabilitation (all levels, very low strength of evidence) but not at other time points; another study observed a statistically significant 6 point improvement in ASIA Impairment Scale (AIS) among patients with AIS B, C, or D, but not for those with AIS A (very low strength of evidence). In one study of acute central cord syndrome without instability, a clinically and statistically meaningful improvement in total motor scores was reported at 6 and 12 months in patients treated early (versus late). There were, however, no significant differences in AIS improvement between early and late surgical groups at 6- or 12-months (very low strength of evidence). One of 3 studies found a shorter length of hospital stay associated with early surgical decompression. Of 3 studies reporting on safety, no significant differences in rates of complications (including mortality, neurologic deterioration, pneumonia or pressure ulcers) were noted between early and late decompression groups. Conclusions: Results surrounding the efficacy of early versus late decompressive surgery, as well as the quality of evidence available, were variable depending on the level of SCI, timing of follow-up, and specific outcome considered. Existing evidence supports improved neurological recovery among cervical SCI patients undergoing early surgery; however, evidence regarding remaining SCI populations and clinical outcomes was inconsistent.

The Impact of Mean Arterial Pressure on Functional Outcome Post Trauma-Related Acute Spinal Cord Injury: A Scoping Systematic Review of the Human Literature

2016 ◽  
Vol 33 (1) ◽  
pp. 3-15 ◽  
Author(s):  
Behzad Sabit ◽  
Frederick Adam Zeiler ◽  
Neil Berrington
Keyword(s):  
Systematic Review ◽  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Mean Arterial Pressure ◽  
Arterial Pressure ◽  
Functional Outcome ◽  
Acute Spinal Cord Injury ◽  
Cochrane Library ◽  
Cord Injury ◽  
The Impact

Purpose: To perform a scoping systematic review on the literature surrounding mean arterial pressure (MAP) and functional outcomes post traumatic acute spinal cord injury (ASCI). Methods: We performed a systematic review of the literature via searching MEDLINE, BIOSIS, EMBASE, Global Health, SCOPUS, and Cochrane Library from inception to January 2015. We also performed a handsearch of various published meeting proceedings. Through a 2-step review process, employing 2 independent reviewers, we selected articles for the final review based on predefined inclusion/exclusion criteria. Results: Nine studies were included in the final review. Only 2 were prospective studies. All studies documented some degree of objective functional outcome in relation to MAP posttraumatic ASCI. Four studies documented a relation between higher MAP and improved functional outcome. Five studies failed to show any relationship between MAP and functional outcome. Conclusions: Although no definitive conclusions could be reached based on the data collected, this study does give valuable insight into future avenues of research on the topic of hemodynamic management in traumatic ASCI as well as provides guidelines for refinement of future study design.

Vasopressor support in managing acute spinal cord injury: current knowledge

2019 ◽  
Vol 63 (3) ◽  
Author(s):  
John K. Yue ◽  
Rachel E. Tsolinas ◽  
John F. Burke ◽  
Hansen Deng ◽  
Pavan S. Upadhyayula ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Current Knowledge ◽  
Acute Spinal Cord Injury ◽  
Vasopressor Support ◽  
Cord Injury
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