Study challenges current standard for managing blood pressure in people with spinal cord injury – About Your Online Magazine


New research from the International Collaboration on Repair Findings (ICORD) challenges the current standard for blood pressure management in people with spinal cord injury (SCI).

The results, published today in Nature Communications, could lead to a change in the way that newly injured patients have their blood pressure controlled, potentially increasing their chances of retaining more functions in the long run.

This study, led by leading ICORD researchers, Dr. Christopher West and Dr. Brian Kwon, demonstrated that after high thoracic spinal cord injury, the heart’s ability to contract is impaired, leading to reduced spinal cord blood flow.

Upper thoracic SCI usually refers to injuries that affect the abdominal and lumbar muscles and legs, usually resulting in paraplegia, while arm and hand function may not be affected.

Currently, a patient undergoing treatment for acute SCI – a traumatic injury that hurts, partially or totally tears the spinal cord – has his blood pressure controlled with medications that cause his blood vessels to constrict to increase blood pressure.

In this study, the research team tested an experimental treatment aimed at making the heart beat faster, which increased the amount of ejected blood and also increased blood pressure.

The main difference is that, targeting the heart, we increase blood pressure by increasing blood flow, rather than causing blood vessels to narrow. This is important because, by increasing blood flow, we can supply more blood and oxygen to the spinal cord, which should minimize damage to the epicenter of the injury and therefore reduce the severity of the injury and bleeding in the spinal cord, both of which should improve the chances of people with SCI to maintain more functions. “

Dr. Christopher West, Principal Researcher, ICORD, University of British Columbia

This may mean that, in the future, an individual newly admitted to the hospital may receive a different medication during the initial post-injury treatment period. If proven to be effective in humans with SCI, it can improve your chances of retaining more functions in the long run.

“It is important to note that one of the only things we can currently do for patients with acute SCI is to try to optimize the supply of blood and oxygen to the injured spinal cord to prevent further secondary injuries,” said Kwon.

“We need to look for ways to provide this care in the most effective way possible, as any part of the spinal cord function that could be improved by new approaches like this would potentially have a major impact on the patient.”

Source:

Newspaper reference:

Williams, A. M., et al. (2020) Cardiocentric hemodynamic management improves oxygenation of the spinal cord and attenuates hemorrhage in acute spinal cord injury. Nature Communications. doi.org/10.1038/s41467-020-18905-8.

Paula Fonseca