scholarly journals Study of 24 Hours/2 day Monitoring of Blood Pressure in Subjects with Traumatic Paraplegia

2021 ◽  
Vol 3 (4) ◽  
pp. 53-58
Author(s):  
Vandana Chaudhary ◽  
Narsingh Verma ◽  
Sunita Tiwari ◽  
R. N. Srivastava ◽  
Dileep Verma
Keyword(s):  
Blood Pressure ◽  
Systemic Blood Pressure ◽  
Autonomic Dysreflexia ◽  
Baseline Heart Rate ◽  
Continuous Variables ◽  
Double Product ◽  
Cord Injury ◽  
Fall From Height ◽  
The Mean ◽  
Upper Thoracic

Cardiovascular dysfunction and cognitive decline are more common in traumatic spinal cord injury (SCI). Most people with a cervical or upper-thoracic SCI usually experience conditions called orthostatic hypotension and autonomic dysreflexia, which are described by the serious changes in systemic blood pressure. To evaluate baseline heart rate (HR), baseline blood pressure (BP) and ABPM monitoring in traumatic paraplegia patients. In this study, total 36 diagnosed of paraplegia patients was based on Asia Impairment Scale (AIS), paralysed by RTA, or fall from height within 7 days of injury were included in this study. The blood pressure was monitoring for 24 hour/2 day and repeated after 12th day of first monitoring. Ambulatory blood pressure was monitored by ABPM machine at HALF hourly from 6 am – 10 pm and one hourly from 10 pm – 6 am. All the continuous variables were compared by t- test. The night dipping (Systole) and morning surge (Systole) were significantly lower at 12th days as compared to within 7 Days (p=0.002). Whereas the diurnal Index (Diastole) and diurnal Index (MAP) were comparable in between within 7 days and 12th days. The mean SBP max and SBP min were significantly lower at 12th day as compared to within 7 days. Whereas DBP max and min were comparable in between within 7 days and at 12th days. The changes in min., max and mean double product (All, active periods, and passive periods) were also not found to be statistically significant in between within 7 days and at 12th day. The traumatic paraplegic patients have altered diurnal index, morning surge, night dipping and systolic blood pressure on APBM monitoring.

scholarly journals The Blood Pressure Pendulum following Spinal Cord Injury: Implications for Vascular Cognitive Impairment

2019 ◽  
Vol 20 (10) ◽  
pp. 2464 ◽  
Author(s):  
Rahul Sachdeva ◽  
Tom E. Nightingale ◽  
Andrei V. Krassioukov
Keyword(s):  
Blood Pressure ◽  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Cognitive Impairment ◽  
Systemic Blood Pressure ◽  
Vascular Cognitive Impairment ◽  
Convincing Evidence ◽  
Autonomic Dysreflexia ◽  
Cord Injury ◽  
Upper Thoracic

Cognitive impairment following spinal cord injury (SCI) has received considerable attention in recent years. Among the various systemic effects of SCI that contribute towards cognitive decline in this population, cardiovascular dysfunction is arguably one of the most significant. The majority of individuals with a cervical or upper-thoracic SCI commonly experience conditions called orthostatic hypotension and autonomic dysreflexia, which are characterized by dangerous fluctuations in systemic blood pressure (BP). Herein, we review the potential impact of extreme BP lability on vascular cognitive impairment (VCI) in individuals with SCI. Albeit preliminary in the SCI population, there is convincing evidence that chronic hypotension and hypertension in able-bodied individuals results in devastating impairments in cerebrovascular health, leading to VCI. We discuss the pertinent literature, and while drawing mechanistic comparisons between able-bodied cohorts and individuals with SCI, we emphasize the need for additional research to elucidate the mechanisms of cognitive impairment specific to the SCI population. Lastly, we highlight the current and potential future therapies to manage and treat BP instability, thereby possibly mitigating VCI in the SCI population.

Intracranial pressure in the normal monkey while awake and asleep

1979 ◽  
Vol 51 (2) ◽  
pp. 206-210 ◽  
Author(s):  
Gündüz Gücer ◽  
Lawrence J. Viernstein
Keyword(s):  
Blood Pressure ◽  
Intracranial Pressure ◽  
Systemic Blood Pressure ◽  
Macaque Monkey ◽  
Short Term ◽  
Content Type ◽  
Plateau Waves ◽  
Normal Monkey ◽  
The Mean ◽  
Cervical Ganglia

✓ Intracranial pressure (ICP) was recorded continuously by telemetry in seven normal monkeys trained to eat, sleep, and live in a primate chair. Electroencephalography, electromyography, and blood pressure were also measured by conventional means. During wakefulness and all stages of sleep except desynchronized sleep, the ICP record showed small short-term variations in pressure. However, during desynchronized sleep, the mean ICP rose on the average to 170 ± 6 mm H2O above the ICP levels in the other states of sleep, and the pulsation pressure variation increased by a factor of three. The episodes occurred 10 ± 2 times during the night and lasted for 6.8 ± 1.4 minutes, during which the average systemic blood pressure decreased by 19 ± 1.6 mm Hg. These ICP waves occurring during desynchronized sleep resemble the plateau waves described by Lundberg, but are of smaller magnitude and they appear to be a normal characteristic of sleep in the macaque monkey. Bilateral sympathectomy of the superior cervical ganglia in four of the monkeys did not alter significantly the duration, amplitude, or frequency of occurrence of the ICP waves during desynchronized sleep.

Effect of Mesenteric Ischemia/Reperfusion on Spinal Cord Injury following Transient Aortic Occlusion in Rabbits

2002 ◽  
Vol 9 (2_suppl) ◽  
pp. II-44-II-50 ◽  
Author(s):  
Nicholas J. Morrissey ◽  
Ilkka Kantonen ◽  
Harry Liu ◽  
Mohamed Sidiqui ◽  
Michael L. Marin ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Mesenteric Ischemia ◽  
Ischemia Reperfusion ◽  
Rabbit Model ◽  
Systemic Blood Pressure ◽  
Aortic Occlusion ◽  
Vessel Occlusion ◽  
Bowel Infarction ◽  
Cord Injury ◽  
Transient Aortic Occlusion

Purpose: To investigate in a rabbit model if prolonged periods of mesenteric ischemia followed by reperfusion may affect the rate of neurological complications. Methods: An infrarenal aortic snare, which consisted of a Silastic vessel loop whose ends were passed through plastic tubing, was placed in 50 male New Zealand white rabbits. In 40 of these animals, a similar but smaller device was placed around the superior mesenteric artery (SMA); all devices were exteriorized to allow vessel occlusion in the awake animal. The aorta was occluded for 12 minutes in the 10 control and 40 experimental animals, but the experimental rabbits also had occlusion of the SMA for varying intervals: 10 minutes (group 1), 12 minutes (group 2), and 18 minutes (group 3). To assess the hemodynamic effects of aortic and aortic/SMA occlusion, select control and test animals had blood pressure and heart rate monitoring via indwelling carotid catheters during the occlusion periods. The animals were euthanized, and spinal cords from paralyzed and normal rabbits were examined histologically Results: Neurological deficit occurred in 20% of controls and in 70%, 80%, and 100% in the experimental groups, respectively. There were no significant differences in systemic blood pressure at any time point during occlusion and reperfusion in the monitored control or test animals. There was no evidence of thrombosis of spinal arteries on histological analysis, nor was there evidence of bowel infarction at the time of sacrifice in animals undergoing combined aortic/SMA occlusion. Conclusions: Mesenteric ischemia/reperfusion worsens the neurological outcome in animals undergoing transient aortic occlusion. This observation is independent of hemodynamic influences and not the result of spinal artery thrombosis.

Autonomic Dysreflexia

2017 ◽  
Author(s):  
Koffi Kla
Keyword(s):  
Blood Pressure ◽  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Clinical Syndrome ◽  
Autonomic Dysreflexia ◽  
Antihypertensive Medications ◽  
Blood Pressure Elevation ◽  
Sudden Rise ◽  
Cord Injury ◽  
Trigger Stimulus

Autonomic dysreflexia (AD), a potentially emergent clinical syndrome that can occur in patients with spinal cord injury, is characterized by a sudden rise in blood pressure caused by uncontrolled sympathetic activation of the autonomic system below the level of the lesion. When caring for spinal cord injury (SCI) patients, a pretreatment plan should be in place if an AD episode occurs. Physical manifestations of an AD episode can include headache, flushing, and diaphoresis above the lesion. Treatment should be aimed at identifying and eliminating the trigger stimulus and must be prompt to avoid serious complications of blood pressure elevation such as seizures, intracranial hemorrhage, myocardial infarction, or even death. When nonpharmacological measures fail, quick-onset, short-acting antihypertensive medications should be given to lower blood pressure.

Splanchnic baroreceptors in the dog

1960 ◽  
Vol 199 (2) ◽  
pp. 335-340 ◽  
Author(s):  
Ewald E. Selkurt ◽  
Carl F. Rothe
Keyword(s):  
Blood Pressure ◽  
Arterial Pressure ◽  
Systemic Blood Pressure ◽  
Systemic Arterial Pressure ◽  
Baroreceptor Reflex ◽  
Mesenteric Arteries ◽  
Intraluminal Pressure ◽  
Hemodynamic Effects ◽  
Systemic Blood ◽  
The Mean

The hemodynamic effects of systemic blood pressure of varying intraluminal pressure in the celiac and superior mesenteric arteries through a range of 20–210 mm Hg were examined in dogs. Responses were compared to a smaller series of cats. Systemic arterial pressure in the dogs rose and fell only about 10% from the mean through this range of decrease and increase, respectively, in the splanchnic arteries. By comparison, comparable decrements of pressure in the celiac and mesenteric arteries of cats gave marked increases in pressure averaging 74%. It was found that the sino-aortic reflexes held the splanchnic mechanism in check in the dog for with sinus denervation the response was significantly increased. Evidence indicated that the responses could be explained on a hydrodynamic basis and that splanchnic baroreceptor reflex activity in the dog is slight.

Autonomic dysreflexia during sperm retrieval in spinal cord injury: influence of lesion level and sildenafil citrate

2005 ◽  
Vol 99 (1) ◽  
pp. 53-58 ◽  
Author(s):  
A. William Sheel ◽  
Andrei V. Krassioukov ◽  
J. Timothy Inglis ◽  
Stacy L. Elliott
Keyword(s):  
Blood Pressure ◽  
Spinal Cord ◽  
Heart Rate ◽  
Spinal Cord Injury ◽  
Autonomic Dysreflexia ◽  
Sildenafil Citrate ◽  
Vibratory Stimulation ◽  
Arterial Blood ◽  
Cord Injury ◽  
Penile Vibratory Stimulation

Autonomic dysreflexia (AD) can occur during penile vibratory stimulation in men with spinal cord injury, but this is variable, and the association with lesion level is unclear. The purpose of this study was to characterize the cardiovascular responses to penile vibratory stimulation in men with spinal cord injury. We hypothesized that those with cervical injuries would demonstrate a greater degree of AD compared with men with thoracic injuries. We also questioned whether the rise in blood pressure could be attenuated by sildenafil citrate. Participants were classified as having cervical ( n = 8) or thoracic ( n = 5) injuries. While in a supine position, subjects were instrumented with an ECG, and arterial blood pressure was determined beat by beat. Subjects reported to the laboratory twice and received an oral dose of sildenafil citrate (25–100 mg) or no medication. Penile vibratory stimulation was performed using a handheld vibrator to the point of ejaculation. At ejaculation during the nonmedicated trials, the cervical group had a significant decrease in heart rate (−5–10 beats/min) and increase in mean arterial blood pressure (+70–90 mmHg) relative to resting conditions, whereas the thoracic group had significant increases in both heart rate (+8–15 beats/min) and mean arterial pressure (+25–30 mmHg). Sildenafil citrate had no effect on the change in heart rate or mean arterial pressure in either group. In summary, men with cervical injuries had more pronounced AD during penile vibratory stimulation than men with thoracic injuries. Administration of sildenafil citrate had no effect on heart rate or blood pressure during penile vibratory stimulation in men with spinal cord injury.

scholarly journals Atenolol prevents the formation of expansive hematoma after rhytidoplasty

2014 ◽  
Vol 41 (5) ◽  
pp. 305-310 ◽  
Author(s):  
Amanda Castilho Moreira ◽  
Marcio Moreira ◽  
Sanderland José Tavares Gurgel ◽  
Yasmin Castilho Moreira ◽  
Eguimar Roberto Martins ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Standard Deviation ◽  
Continuous Variables ◽  
Hematoma Formation ◽  
Group A ◽  
The Mean ◽  
Student’S T ◽  
Group B ◽  
Student’S T Test

Objective: To evaluate the perioperative use of atenolol in reducing the incidence of hematoma after rhytidoplasty.Methods: Between January 2007 and February 2013, 80 patients were randomized into two groups: Group A (n = 26) received perioperative atenolol in order to maintain heart rate (PR) around 60 per minute; Group B (n = 54) did not receive atenolol. Both groups underwent the same anesthetic and surgical technique. We monitored blood pressure (BP), HR, hematoma formation and the need for drainage. Patients were followed-up until the 90th postoperative day. The variables were compared between the groups using the ANOVA test. Continuous variables were presented as mean ± standard deviation and the differences were compared with the Student's t test. Values of p d" 0.05 were considered significant.Results: In group A the mean BP (110-70mmHg ± 7.07) and HR (64 / min ± 5) were lower (p d" 0.05) than in group B (135-90mmHg ± 10.6) and (76 / min ± 7.5), respectively. There were four cases of expansive hematoma in group B, all requiring reoperation for drainage, and none in group A (p d" 0,001).Conclusion: The perioperative use of atenolol caused a decrease in blood pressure and heart rate and decreased the incidence of expanding hematoma after rhytidectomy.

scholarly journals Surgical timing for cervical and upper thoracic injuries in patients with polytrauma

2017 ◽  
Vol 27 (6) ◽  
pp. 633-637 ◽  
Author(s):  
Daniel Lubelski ◽  
Suzanne Tharin ◽  
John J. Como ◽  
Michael P. Steinmetz ◽  
Heather Vallier ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Injury Severity ◽  
Categorical Variables ◽  
Spine Injury ◽  
Complication Rates ◽  
Continuous Variables ◽  
Cervical Spine Injuries ◽  
Protocol Group ◽  
Cord Injury ◽  
Upper Thoracic

OBJECTIVEFew studies have investigated the advantages of early spinal stabilization in the patient with polytrauma in terms of reduction of morbidity and mortality. Previous analyses have shown that early stabilization may reduce ICU stay, with no effect on complication rates.METHODSThe authors prospectively observed 340 polytrauma patients with an Injury Severity Score (ISS) of greater than 16 at a single Level 1 trauma center who were treated in accordance with a protocol termed “early appropriate care,” which emphasizes operative treatment of various fractures within 36 hours of injury. Of these patients, 46 had upper thoracic and/or cervical spine injuries. The authors retrospectively compared patients treated according to protocol versus those who were not. Continuous variables were compared using independent t-tests and categorical variables using Fisher’s exact test. Logistic regression analysis was performed to account for baseline confounding factors.RESULTSFourteen of 46 patients (30%) did not undergo surgery within 36 hours. These patients were significantly more likely to be older than those in the protocol group (53 vs 38 years, p = 0.008) and have greater body mass index (BMI; 33 vs 27, p = 0.02), and they were less likely to have a spinal cord injury (SCI) (82% did not have an SCI vs 44% in the protocol group, p = 0.04). In terms of outcomes, patients in the protocol-breach group had significantly more total ventilator days (13 vs 6 days, p = 0.02) and total ICU days (16 vs 9 days, p = 0.03). Infection rates were 14% in the protocol-breach group and 3% in the protocol group (p = 0.2) Total complications trended toward being statistically significantly more common in the protocol-breach group (57% vs 31%). After controlling for potential confounding variables by logistic regression (including age, sex, BMI, race, and SCI), total complications were significantly (p < 0.05) greater in the protocol-breach group (OR 29, 95% CI 1.9–1828). This indicates that the odds of developing “any complication” were 29 times greater if treatment was delayed more than 36 hours.CONCLUSIONSEarly surgical stabilization in the polytrauma patient with a cervical or upper thoracic spine injury is associated with fewer complications and improved outcomes. Hospitals may consider the benefit of protocols that promote early stabilization in this patient population.

Sign in / Sign up

Export Citation Format

Share Document