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Heterogeneous effect of increasing spinal cord perfusion pressure on sensory evoked potentials recorded from acutely injured human spinal cord

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العنوان: Heterogeneous effect of increasing spinal cord perfusion pressure on sensory evoked potentials recorded from acutely injured human spinal cord
المؤلفون: David Martín López, Marios C. Papadopoulos, Argyro Zoumprouli, Helen V. Sheen, Mathew J. Gallagher, Florence R. A. Hogg, Samira Saadoun
المصدر: Journal of Critical Care. 56:145-151
بيانات النشر: Elsevier BV, 2020.
سنة النشر: 2020
مصطلحات موضوعية: Adult, Male, Microdialysis, Cord, Blood Pressure, Electric Stimulation Therapy, Stimulation, Critical Care and Intensive Care Medicine, Catheterization, Young Adult, 03 medical and health sciences, 0302 clinical medicine, Cerebrospinal Fluid Pressure, Evoked Potentials, Somatosensory, Pyruvic Acid, Pressure, medicine, Humans, Lactic Acid, Spinal cord injury, Spinal Cord Injuries, Monitoring, Physiologic, business.industry, musculoskeletal, neural, and ocular physiology, 030208 emergency & critical care medicine, Middle Aged, Spinal cord, medicine.disease, Magnetic Resonance Imaging, Electrophysiology, Perfusion, medicine.anatomical_structure, Blood pressure, Spinal Cord, 030228 respiratory system, Somatosensory evoked potential, Anesthesia, Female, Tibial Nerve, Tomography, X-Ray Computed, business
الوصف: Purpose To investigate the effect of increasing spinal cord perfusion pressure (SCPP) on sensory evoked potentials (SEPs) and injury site metabolism in patients with severe traumatic spinal cord injury TSCI. Materials and methods In 12 TSCI patients we placed a pressure probe, a microdialysis catheter and a strip electrode with 8 contacts on the surface of the injured cord. We monitored SCPP, lactate-to-pyruvate ratio (LPR) and SEPs (after median or posterior tibial nerve stimulation). Results Increase in SCPP by ~20 mmHg produced a heterogeneous response in SEPs and injury site metabolism. In some patients, SEP amplitudes increased and the LPR decreased indicating improved tissue metab olism. In others, SEP amplitudes decreased and the LPR increased indicating more impaired metabolism. Compared with patients who did not improve at follow-up, those who improved had significantly more electrode contacts with SEP amplitude increase in response to increasing SCPP. Conclusions Increasing SCPP after acute, severe TSCI may be beneficial (if associated with increase in SEP amplitude) or detrimental (if associated with decrease in SEP amplitude). Our findings support individualized management of patients with acute, severe TSCI guided by monitoring from the injury site rather than applying universal blood pressure targets as is current clinical practice.
وصف الملف: application/vnd.openxmlformats-officedocument.wordprocessingml.document
تدمد: 0883-9441
1557-8615
URL الوصول: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::b557ac318079b2d46eb5ce7af36b07bd
https://doi.org/10.1016/j.jcrc.2019.12.019
حقوق: OPEN
رقم الأكسشن: edsair.doi.dedup.....b557ac318079b2d46eb5ce7af36b07bd
قاعدة البيانات: OpenAIRE
الوصف
تدمد:08839441
15578615