Tight BP control may lead to more mobility in new patients with paralysis

The American Association of Neurological Surgeons estimate that around 17,000 Spinal Cord Injuries (SCI) occur each year in the United States. The risk of mortality is highest in the first year after the injury, according to the World Health Organization (WHO) however, complete recovery is rare.

Maintenance of blood pressure within a tightly defined range during surgery is associated with better functional recovery, even in patients with the most-severe spinal cord injuries, suggests a new study. Such patients may stand a better chance of regaining some mobility and functionality after surgery according to a new study by researchers at UC San Francisco.

The findings of the study are published in eLife journal.

The objective of the study was that theprevious studies in rodents had showed Mean Arterial Pressure (MAP) during SCI surgery predicted long-term functional recovery, hence the present multicenter study in patients.

The study used Intra-operative monitoring records and neurological outcome data were extracted (n=118 patients).Asimilarity of network of patients was developed from a low-dimensional space embedded using a non-linear algorithm, Isomap, and ensured topological extraction using persistent homology metrics. Confirmatory analysis was conducted through regression methods.

The results of the study were

• Network analysis pointed out that time outside of an optimum MAP range (hypotension or hypertension) during surgery was associated with lower likelihood of neurological recovery at hospital discharge.

• Logistic and LASSO regression confirmed these findings, revealing an optimal MAP range of 76-[104-117] mmHg associated with neurological recovery.

Espin and team concluded that "We show that deviation from this optimal MAP range during SCI surgery predicts lower probability of neurological recovery and suggest new targets for therapeutic intervention."

Reference: https://elifesciences.org/articles/68015