Combined medical and surgical treatment after acute spinal cord injury: results of a prospective pilot study to assess the merits of aggressive medical resuscitation and blood pressure management

• DOI: 10.3171/jns.1997.87.2.0239
• Publication Date: 2009-06-10T18:34:31Z
• Authors: Fernando L. Vale; Jennifer Burns; Amie B. Jackson; Mark N. Hadley
• Keywords: Adult; Male; Time Factors; Resuscitation; Blood Pressure; Pilot Projects; 3. Good health; 03 medical and health sciences; 0302 clinical medicine; Humans; Female; Prospective Studies; Spinal Cord Injuries

✓ The optimal management of acute spinal cord injuries remains to be defined. authors prospectively applied resuscitation principles volume expansion and blood pressure maintenance 77 patients who presented with neurological deficits as a result occurring from C-1 through T-12 in an effort maintain flow prevent secondary injury. According the Intensive Care Unit protocol, all were managed by using Swan—Ganz arterial catheters treated immobilization fracture reduction indicated. Intravenous fluids, colloid, vasopressors administered necessary mean above 85 mm Hg. Surgery was performed for decompression stabilization, fusion selected cases. Sixty-four have been followed at least 12 months postinjury means detailed assessments functional ability evaluations. Sixty percent complete cervical improved one Frankel or American Spinal Injury Association (ASIA) grade last follow-up review. Thirty regained walk 20% had return bladder function 1 year postinjury. Thirty-three thoracic ASIA grade. Approximately 10% function. As 12-month review, 92% demonstrated clinical improvement after sustaining incomplete compared their initial status. Ninety-two 88% Eighty-eight significant improvements able 63% conclude that enhanced outcome observed injury this study addition to, and/or distinct from, any potential benefit provided surgery. Early aggressive medical (volume augmentation) optimizes recovery trauma.