Mean Arterial Blood Pressure Management of Acute Traumatic Spinal Cord Injured Patients during the Pre-Hospital and Early Admission Period

Jin W. Tee, Farhaan Altaf, Lise Belanger, Tamir Ailon, John Street, Scott Paquette, Michael Boyd, Charles G. Fisher, Marcel F. Dvorak, Brian K. Kwon

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7 Citations (Scopus)

Abstract

The optimization and maintenance of mean arterial blood pressure (MAP) and the general avoidance of systemic hypotension for the first 5-7 days following acute traumatic spinal cord injury (tSCI) is considered to be important for minimizing secondary spinal cord ischemic damage. The characterization of hemodynamic parameters in the immediate post-injury stage prior to admission to a specialized spine unit has not been previously reported. Here we describe the blood pressure management of 40 acute tSCI patients in the early post-injury phases of care prior to their arrival in a specialized spinal injury high dependency unit (HDU), intensive care unit (ICU), or operating room (OR). This study found that a significant proportion of these patients experience periods of relative hypotension prior to their admission to a specialized spinal unit. In particular, the mean calculated MAP was 78.8 mm Hg, with 52% of MAP measurements <80 mm Hg at primary receiving hospitals. Despite having a mean calculated MAP of 83.3 mm Hg in the emergency room of the tertiary hospital, 40% of the MAP measurements were <80 mm Hg. Although stringent monitoring and management of MAP may be facilitated and adhered to in a spinal HDU, ICU, or OR, it is important to recognize that acute traumatic SCI patients may experience many periods of relative hypotension prior to their arrival in such specialized units. This study highlights the need for education and awareness to optimize the hemodynamic management of acute SCI patients during the immediate post-injury period.

Original languageEnglish
Pages (from-to)1271-1277
Number of pages7
JournalJournal of Neurotrauma
Volume34
Issue number6
DOIs
Publication statusPublished - 15 Mar 2017
Externally publishedYes

Keywords

  • acute
  • cardiopulmonary
  • clinical guidelines
  • hemodynamic
  • hypotension
  • MAP
  • SCI
  • secondary injury

Cite this

Tee, J. W., Altaf, F., Belanger, L., Ailon, T., Street, J., Paquette, S., Boyd, M., Fisher, C. G., Dvorak, M. F., & Kwon, B. K. (2017). Mean Arterial Blood Pressure Management of Acute Traumatic Spinal Cord Injured Patients during the Pre-Hospital and Early Admission Period. Journal of Neurotrauma, 34(6), 1271-1277. https://doi.org/10.1089/neu.2016.4689