Pilot study: advanced haemodynamic monitoring after acute spinal cord injury
- \(\bf Background:\) Although the use of vasopressors to maintain haemodynamic goals after acute spinal cord injury (SCI) is still recommended, evidence regarding the target values and possible risks of this practice is limited, and data on haemodynamic parameters unaffected by catecholamines are rare. In this pilot study, we show the haemodynamic profile of patients with acute SCI mainly unaffected by vasopressor use and other factors that influence the cardiovascular system. \(\bf Methods:\) From March 2018 to March 2020, we conducted a prospective, single-centre pilot study of 30 patients with acute SCI. Factors that could affect the cardiocirculatory system other than SCI (sepsis, pre-existing heart disease or multiple trauma) led to exclusion. A total of 417 measurements were performed using the PiCCO™ system. \(\bf Results:\) The mean systemic vascular resistance index (SVRI, 1447.23 \(\pm\) 324.71 \(dyn*s*cm^{−5*}m^{2}\)), mean central venous pressure (CVP, \(\it 10.69\) \(\pm\) \(\it 3.16\)) and mean global end-diastolic volume index (GEDVI, 801.79 \(\pm\) 158.95 \(ml/m^{2}\)) deviated from the reference range, while the mean cardiac index (CI), mean stroke volume index (SVI), mean arterial pressure (MAP), and mean heart rate (HR) were within the reference range, as indicated in the literature. A mixed model analysis showed a significant negative relationship between norepinephrine treatment and MAP (83.97 vs. 73.69 mmHg, \(\it p\) < 0.001), SVRI (1463.40 vs. 1332.14 \(dyn*s*cm^{−5*}m^{2}\), \(\it p\) = 0.001) and GEDVI (808.89 vs. 759.39 \(ml/m^{2}\), \(\it p\) = 0.001). \(\bf Conclusion:\) These findings could lead to an adaptation of the target range for SVRI and MAP in patients with acute SCI and therefore reduce the use of vasopressors.
Author: | Niklas DrotleffORCiDGND, Oliver JansenGND, Christina WeckwerthORCiDGND, Mirko AachORCiDGND, Thomas Armin SchildhauerORCiDGND, Christian WaydhasORCiDGND, Uwe HamsenORCiDGND |
---|---|
URN: | urn:nbn:de:hbz:294-104056 |
DOI: | https://doi.org/10.1186/s12871-022-01806-2 |
Parent Title (English): | BMC anesthesiology |
Subtitle (English): | keep the pressure up? |
Publisher: | BioMed Central |
Place of publication: | London, Vereinigtes Königreich |
Document Type: | Article |
Language: | English |
Date of Publication (online): | 2023/10/26 |
Date of first Publication: | 2022/09/01 |
Publishing Institution: | Ruhr-Universität Bochum, Universitätsbibliothek |
Tag: | Open Access Fonds Advanced haemodynamic monitoring; MAP goals; Spinal cord injury; Transpulmonary thermodilution |
Volume: | 22 |
Issue: | Article 277 |
First Page: | 277-1 |
Last Page: | 277-7 |
Note: | Article Processing Charge funded by the Deutsche Forschungsgemeinschaft (DFG) and the Open Access Publication Fund of Ruhr-Universität Bochum. |
Institutes/Facilities: | Berufsgenossenschaftliches Universitätsklinikum Bergmannsheil, Chirurgische Klinik und Poliklinik |
Dewey Decimal Classification: | Technik, Medizin, angewandte Wissenschaften / Medizin, Gesundheit |
open_access (DINI-Set): | open_access |
Licence (English): | Creative Commons - CC BY 4.0 - Attribution 4.0 International |