Overview
The purpose of this study is to assess the effect of various hemodynamic management strategies on functional neurologic outcomes and non-neurologic adverse events in the first 5 days following acute spinal cord injury (SCI). The hemodynamic management strategies assessed include targeting a mean arterial blood pressure (MAP) goal of 85-90 mmHg, targeting a spinal cord perfusion pressure (SCPP) goal of ≥65 mmHg, or targeting normal hemodynamics, which is a MAP goal of ≥65 mmHg.
Eligibility
Inclusion Criteria:
- Traumatic spinal cord injury
Exclusion Criteria:
- Patients with an injury from a trauma that penetrates the spinal cord (i.e., gunshot or knife wound resulting in cord transection)
- Preexisting neurologic or spinal cord injury
- Severe traumatic brain injury as measured by a best resuscitated Glasgow Coma Scale (GCS) score of <8 at 24 hours following injury
- Presence of traumatic injuries that preclude spine surgery within 24 hours of presentation
- Concomitant injury/illness requiring targeted blood pressure management (e.g., injury to the aorta, aortic dissection, hemorrhagic stroke)
- Preexisting history of neuromotor disorders (i.e., cerebral palsy, Parkinson disease, etc.)
- Not expected to survive >24h
- Cord transection identified by radiologist and agreed upon by the spine surgery team
- Injury below spinal cord level L1
- Prisoners
- Pregnant women