Optimizing Hemodynamic Support of Acute Spinal Cord Injury Based on Injury Mechanism
Technical Report,30 Sep 2015,29 Sep 2016
University of British Columbia Vancouver Canada
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In Year 2 we finalized the head-to-head comparison of NE, and PE infusion after SCI on spinal cord oxygenation luminescence-based optical sensor, perfusion laser-Doppler flowmetry, intraparenchymal pressure fiber optic probe and downstream metabolic responses microdialysis. Correlation analysis revealed that changed in MAP during NE and PE in the compressed state of the spinal cord were not associated with positive changes in neither SCBF not PaPO2. Notably during the decompressed state, there was no relation between changes in MAP and SCBF with PE, while an almost linear correlation existed with the use of NE. Notably, glutamate and LP ratio levels were significantly lower with the use of NE during decompression compared to no infusion, 1 hour after infusion had stopped indicative of reduced glutamate toxicity and ischemia. This is most likely due to the improved perfusion after decompression as observed with NE. These results suggest that NE may be preferable to PE if vasopressor support is not required post SCI to maintain elevated MAPs in accordance with published guidelines.
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