scholarly journals Mechanisms inducing autonomic dysreflexia during urinary bladder distention in rats with spinal cord injury

Spinal Cord ◽  
2014 ◽  
Vol 53 (3) ◽  
pp. 190-194 ◽  
Author(s):  
T Yoshizawa ◽  
K Kadekawa ◽  
P Tyagi ◽  
S Yoshikawa ◽  
R Takahashi ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Urinary Bladder ◽  
Autonomic Dysreflexia ◽  
Bladder Distention ◽  
Cord Injury

scholarly journals A Simple Radiological Technique for Demonstration of Incorrect Positioning of a Foley Catheter with Balloon Inflated in the Urethra of a Male Spinal Cord Injury Patient

2006 ◽  
Vol 6 ◽  
pp. 2445-2449 ◽  
Author(s):  
Subramanian Vaidyanathan ◽  
Peter L. Hughes ◽  
Bakul M. Soni
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Urinary Bladder ◽  
Contrast Medium ◽  
Foley Catheter ◽  
Autonomic Dysreflexia ◽  
X Ray ◽  
Malpractice Claims ◽  
Cord Injury ◽  
Radiological Technique

In a male patient with cervical spinal cord injury, the urinary bladder may go into spasm when a urethral catheter is removed and a new Foley catheter is inserted. Before the balloon is inflated, the spastic bladder may push the Foley catheter out or the catheter may slip out of a small-capacity bladder. An inexperienced health professional may inflate the balloon of a Foley catheter in the urethra without realizing that the balloon segment of the catheter is lying in the urethra instead of the urinary bladder. When a Foley balloon is inflated in the urethra, a tetraplegic patient is likely to develop autonomic dysreflexia. This is a medical emergency and requires urgent treatment. Before the incorrectly placed Foley catheter is removed, it is important to document whether the balloon has been inflated in the urinary bladder or not. The clinician should first use the always available tools of observation and palpation at the bedside without delays of transportation. A misplaced balloon will often be evident by a long catheter sign, indicating excessive catheter remaining outside the patient. Radiological diagnosis is not frequently required and, when needed, should employ the technique most readily available, which might be a body and pelvic CT without intravenous contrast. An alternative radiological technique to demonstrate the position of the balloon of the Foley catheter is described. Three milliliters of nonionic X-ray contrast medium, Ioversol (OPTIRAY 300), is injected through the side channel of the Foley catheter, which is used for inflating the balloon. Then, with a catheter-tip syringe, 30 ml of sterile Ioversol is injected through the main lumen of the Foley catheter. Immediately thereafter, an X-ray of the pelvis (including perineum) is taken. By this technique, both the urinary bladder and balloon of the Foley catheter are visualized by the X-ray contrast medium. When a Foley catheter has been inserted correctly, the balloon of the Foley catheter should be located within the urinary bladder, but when the Foley catheter is misplaced with the balloon inflated in the urethra, a round opaque shadow of the Foley balloon is seen separately below the urinary bladder. This radiological study takes only a few minutes to perform, can be carried out bedside with a mobile X-ray machine, and does not require special expertise or preparations, unlike transrectal ultrasonography. When a Foley balloon is inflated in the urethra, abdominal ultrasonography will show an absence of the Foley balloon within the bladder. The technique described above aids in positive demonstration of a Foley balloon lying outside the urinary bladder. Such documentation proves valuable in planning future treatment, education of health professionals, and settlement of malpractice claims.

34 MECHANISMS INDUCING AUTONOMIC DYSREFLEXIA DURING BLADDER DISTENTION IN RATS WITH SPINAL CORD INJURY

2013 ◽  
Vol 189 (4S) ◽  
Author(s):  
Tsuyoshi Yoshizawa ◽  
Satoru Yoshikawa ◽  
Ryosuke Takahashi ◽  
Satoru Takahashi ◽  
Naoki Yoshimura
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Autonomic Dysreflexia ◽  
Bladder Distention ◽  
Cord Injury

Episodic hypertension due to autonomic dysreflexia in acute and chronic spinal cord-injured rats

1995 ◽  
Vol 268 (5) ◽  
pp. H2077-H2083 ◽  
Author(s):  
A. V. Krassioukov ◽  
L. C. Weaver
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Urinary Bladder ◽  
Arterial Pressure ◽  
Spinal Reflexes ◽  
Autonomic Dysreflexia ◽  
Descending Inhibition ◽  
Bladder Distension ◽  
Cord Injury ◽  
Spinal Cord Injured

Spinal cord injury results in abnormal sympathetic control of the cardiovascular system, consisting of exaggerated reflexes with resulting hypertension and bradycardia that has been termed autonomic dysreflexia. We studied changes in arterial pressure and heart rate caused by colon or urinary bladder distension in unanesthetized acute (7 day) and chronic (30 day) spinal cord-injured rats to evaluate the time course of these responses in an animal model of spinal cord injury. In conscious control rats colon and bladder distension caused brief (2-10 s) pressor responses of 10 mmHg associated with tachycardia and escape reactions. Colon distension in spinal cord-injured rats increased arterial pressure by 41 +/- 2, 22 +/- 3; and 49 +/- 5 mmHg at 24 h and 7 and 30 days after cord transection, respectively. These responses lasted 30 s-5 min and were accompanied by bradycardia. Distension of the urinary bladder caused similar responses in spinal rats after 24 h and 30 days of cord transection. We propose that the initial responses may be related to loss of descending inhibition of spinal reflexes but that plastic changes in the spinal cord is one of the mechanisms for the autonomic dysreflexia occurring 1 mo after injury.

Spinal cord injury and pregnancy

2021 ◽  
pp. 1753495X2110119
Author(s):  
Katherine Robertson ◽  
Felicity Ashworth
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Respiratory Infections ◽  
Obstetric Care ◽  
Autonomic Dysreflexia ◽  
Existing Problems ◽  
Cord Injury ◽  
Relative Rarity ◽  
Obstetric Population ◽  
Tract Infections

Pregnancy in women with spinal cord injury is considered high risk because it may exacerbate many of their existing problems, including autonomic dysreflexia, spasms, decubitus ulcers, urinary tract infections and respiratory infections. Due to the relative rarity of spinal cord injury in the general obstetric population, clinicians often lack familiarity of these specific problems and the women themselves are usually more experienced in their own management than their obstetric team. However, studies have demonstrated that pregnancy outcomes are generally good with appropriate and experienced obstetric care. In this review, we examine the available literature and provide advice on pre-conception counselling and the antenatal, intrapartum and postnatal management of pregnant women with spinal cord injury.

scholarly journals Reduction in Bladder-Related Autonomic Dysreflexia after OnabotulinumtoxinA Treatment in Spinal Cord Injury

2016 ◽  
Vol 33 (18) ◽  
pp. 1651-1657 ◽  
Author(s):  
Renée J. Fougere ◽  
Katharine D. Currie ◽  
Mark K. Nigro ◽  
Lynn Stothers ◽  
Daniel Rapoport ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Autonomic Dysreflexia ◽  
Cord Injury

scholarly journals Plasticity of TRPV1-Expressing Sensory Neurons Mediating Autonomic Dysreflexia Following Spinal Cord Injury

2012 ◽  
Vol 3 ◽  
Author(s):  
Leanne M. Ramer ◽  
A. Peter van Stolk ◽  
Jessica A. Inskip ◽  
Matt S. Ramer ◽  
Andrei V. Krassioukov
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Sensory Neurons ◽  
Autonomic Dysreflexia ◽  
Cord Injury
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