MONDAY, November 22, 2021 (HealthDay News) – Strict blood pressure controls – not too high and not too low – during spinal cord injury surgery can improve patient outcomes, suggests a new study.
“Damage to neurons in spinal cord injuries causes dysregulation of blood pressure, which in turn reduces blood and oxygen supply to stressed spinal cord tissue and exacerbates spinal neuron death,” said co-lead author Abel Torres-Espin, assistant professor of neurological surgery at the University of California, San Francisco.
“Therefore, precise blood pressure management is an important goal for the management of spinal cord injuries,” said Torres-Espin in a press release from the UCSF.
the to learn included 118 patients in two California hospitals treating the most severe trauma. The researchers compared their spinal injury severity levels at admission and discharge.
Grades ranged from A (no movement or sensation below the injury point) to E (normal movement and sensation).
Of the 42 patients whose spinal injuries improved by at least one grade in the hospital, 18 had a Grade A injury; 8, class B; 11, class C; and 5, class D.
Patients with high or low blood pressure during surgery had poorer movement recovery after surgery, the study said.
The best recoveries were associated with maintaining mean arterial pressure between 76 and 104-117 mm Hg during surgery. That’s a narrower range than current guidelines, which are based on smaller clinical trials, according to results published in the journal on Nov. 16 eLife.
“It is particularly interesting that this work has identified the upper limit of the blood pressure range that was previously not considered harmful in clinical practice,” said study co-author Dr. Jonathan Pan, from the Department of Anesthesia and Perioperative Care at UCSF.
“If the results can be validated in our prospective study, it has the potential to provide new guidelines for our blood pressure management for patients with acute spinal cord injury,” he added.
For patients with the most severe Grade A injuries, optimal blood pressure during surgery can be a key factor in improving those injuries to Grade C, the researchers said.
“The difference between Grade A and Grade C can be significant and meaningful in terms of independence and functionality,” said Debra Hemmerle, co-author of the study, a nurse at the UCSF Brain and Spinal Injury Center.
“This means that a patient who would otherwise have to rely on human assistance for their most basic needs might be able to switch from a wheelchair to a bed, walk with aids, and engage in some activities of daily living without assistance She said in the release.
The US National Institute of Neurological Disorders and Stroke has more about it Spinal cord injuries.
SOURCE: University of California, San Francisco, press release, November 16, 2021