Spinal cord injury: is monitoring from the injury site the future?
Samira SaadounMarios C PapadopoulosPublished in: Critical care (London, England) (2016)
This paper challenges the current management of acute traumatic spinal cord injury based on our experience with monitoring from the injury site in the neurointensive care unit. We argue that the concept of bony decompression is inadequate. The concept of optimum spinal cord perfusion pressure, which differs between patients, is introduced. Such variability suggests individualized patient treatment. Failing to optimize spinal cord perfusion limits the entry of systemically administered drugs into the injured cord. We conclude that monitoring from the injury site helps optimize management and should be subjected to a trial to determine whether it improves outcome.
Keyphrases
- spinal cord injury
- spinal cord
- neuropathic pain
- end stage renal disease
- ejection fraction
- newly diagnosed
- healthcare
- chronic kidney disease
- liver failure
- minimally invasive
- prognostic factors
- clinical trial
- study protocol
- quality improvement
- randomized controlled trial
- contrast enhanced
- drug induced
- pain management
- respiratory failure
- phase iii
- smoking cessation
- magnetic resonance