Empiric Targets for Acute Hemodynamic Management for Spinal Cord Injury

A small study suggests that higher targets are associated with better outcomes and that spinal cord perfusion pressure may be particularly important.

Current guidelines recommend that patients with acute traumatic spinal cord injury (SCI) be treated by maintaining mean arterial pressure (MAP) of 85 to 90 mm Hg for 7 days, but this recommendation is based on limited, low-quality evidence. In this study, prospectively collected data from a cohort of 92 patients with acute SCI, all of whom were managed by targeting a MAP of 80 to 85 mm Hg for 5 days from injury, was analyzed to determine the relationship between time spent at specific hemodynamic goals and improvement in American Spinal Injury Association Impairment Scale (AIS) grade.

The authors report that the relative risk for a 1-point increase in AIS scale from baseline increased with higher values of MAP and spinal cord perfusion press…

Reviewing Author

Craig Williamson, MD

Disclosures

Consultant/Advisory BoardNational Football League

RoyaltiesUpToDate, Inc.

Grant/Research SupportNational Institutes of Health

Editorial BoardsNeurocritical Care