Systemic hypothermia in acute cervical spinal cord injury: a case-controlled study

被引:83
作者
Dididze, M.
Green, B. A.
Dietrich, W. Dalton
Vanni, S.
Wang, M. Y.
Levi, A. D. [1 ]
机构
[1] Univ Miami, Miller Sch Med, Lois Pope Life Ctr, Dept Neurol Surg, Miami, FL 33136 USA
关键词
acute cervical SCI; cooling catheter; systemic hypothermia; DEEP VENOUS THROMBOSIS; SCI;
D O I
10.1038/sc.2012.161
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Introduction: Systemic hypothermia remains a promising neuroprotective strategy. There has been recent interest in its use in patients with spinal cord injury (SCI). In this article, we describe our extended single center experience using intravascular hypothermia for the treatment of cervical SCI. Methods: Thirty-five acute cervical SCI patients received modest (33 degrees C) intravascular hypothermia for 48h. Neurological outcome was assessed by the International Standards for Neurological Classification of Spinal Cord Injury scale (ISNCSCI) developed by the American Spinal Injury Association. Local and systemic complications were recorded. Results: All patients were complete ISNCSCI A on admission, but four converted to ISNCSCI B in <24 h post injury. Hypothermia was delivered in 5.76 (+/- 0.45) hours from injury if we exclude four cases with delayed admission (>18 h). Fifteen of total 35 patients (43%) improved at least one ISNCSCI grade at latest follow up 10.07 (+/- 1.03) months. Even excluding those patients who converted from ISNCSCI A within 24h, 35.5% (11 out of 31) improved at least one ISNCSCI grade. Both retrospective (n=14) and prospective (n=21) groups revealed similar number of respiratory complications. The overall risk of any thromboembolic complication was 14.2%. Conclusion: The results are promising in terms of safety and improvement in neurological outcome. To date, the study represents the largest study cohort of cervical SCI patients treated by modest hypothermia. A multi-center, randomized study is needed to determine if systemic hypothermia should be a part of SCI patients' treatment for whom few options exist.
引用
收藏
页码:395 / 400
页数:6
相关论文
共 50 条
  • [41] Neuroprotective assessment of prolonged local hypothermia post contusive spinal cord injury in rodent model
    Loong, Daniel Boon
    Chua, Soo Min
    Prasad, Ankshita
    Kakkos, Ioannis
    Jiang, Wenxuan
    Yue, Mu
    Liu, Xiaogang
    All, Angelo Homayoun
    SPINE JOURNAL, 2018, 18 (03) : 507 - 514
  • [42] Aging after spinal cord injury: an exploratory study
    JS Krause
    Spinal Cord, 2000, 38 : 77 - 83
  • [43] Aging after spinal cord injury: an exploratory study
    Krause, JS
    SPINAL CORD, 2000, 38 (02) : 77 - 83
  • [44] Intraoperative Targeted Temperature Management in Acute Brain and Spinal Cord Injury
    Kraft, Jacqueline
    Karpenko, Anna
    Rincon, Fred
    CURRENT NEUROLOGY AND NEUROSCIENCE REPORTS, 2016, 16 (02) : 1 - 9
  • [45] Early Rapid Neurological Assessment for Acute Spinal Cord Injury Trials
    Battistuzzo, Camila R.
    Smith, Karen
    Skeers, Peta
    Armstrong, Alex
    Clark, Jillian
    Agostinello, Jacqui
    Cox, Shelley
    Bernard, Stephen
    Freeman, Brian J. C.
    Dunlop, Sarah A.
    Batchelor, Peter E.
    JOURNAL OF NEUROTRAUMA, 2016, 33 (21) : 1936 - +
  • [46] Update on traumatic acute spinal cord injury. Part 2
    Mourelo Farina, M.
    Salvador de la Barrera, S.
    Montoto Marques, A.
    Ferreiro Velasco, M. E.
    Vazquez, R. Galeiras
    MEDICINA INTENSIVA, 2017, 41 (05) : 306 - 315
  • [47] Impact of Heterotopic Ossification on Functional Recovery in Acute Spinal Cord Injury
    Franz, Steffen
    Rust, Lukas
    Heutehaus, Laura
    Rupp, Ruediger
    Schuld, Christian
    Weidner, Norbert
    FRONTIERS IN CELLULAR NEUROSCIENCE, 2022, 16
  • [48] Cerebrospinal Fluid Drainage and Induced Hypertension Improve Spinal Cord Perfusion After Acute Spinal Cord Injury in Pigs
    Martirosyan, Nikolay L.
    Kalani, M. Yashar S.
    Bichard, William D.
    Baaj, Ali A.
    Gonzalez, L. Fernando
    Preul, Mark C.
    Theodore, Nicholas
    NEUROSURGERY, 2015, 76 (04) : 461 - 468
  • [49] A Contusive Model of Unilateral Cervical Spinal Cord Injury Using the Infinite Horizon Impactor
    Lee, Jae H. T.
    Streijger, Femke
    Tigchelaar, Seth
    Maloon, Michael
    Liu, Jie
    Tetzlaff, Wolfram
    Kwon, Brian K.
    JOVE-JOURNAL OF VISUALIZED EXPERIMENTS, 2012, (65):
  • [50] Modeling chronic cervical spinal cord injury in aged rats for cell therapy studies
    Martin-Lopez, Maria
    Gonzalez-Munoz, Elena
    Gomez-Gonzalez, Emilio
    Sanchez-Pernaute, Rosario
    Marquez-Rivas, Javier
    Fernandez-Munoz, Beatriz
    JOURNAL OF CLINICAL NEUROSCIENCE, 2021, 94 : 76 - 85