Traumatic cervical spinal cord injury: Comparison of two different blood pressure targets on neurological recovery

Abstract

Background: Controversy exists whether blood pressure augmentation therapy benefits patients suffering from spinal cord injury (SCI). This retrospective comparative study was designed to assess the impact of two different mean arterial pressure (MAP) targets (85–90 mmHg vs. 65–85 mmHg) on neurological recovery after traumatic cervical SCI. Methods: Fifty-one adult patients with traumatic cervical SCI were retrospectively divided into two groups according to their intensive care unit (ICU) MAP targets: 85–90 mmHg (higher MAP group, n = 32) and 65–85 mmHg (lower MAP group, n = 19). Invasive MAP measurements were stored as 2-min median values for 3–7 days. The severity of SCI (AIS grade and neurological level) was evaluated upon ICU stay and during rehabilitation. Neurological recovery was correlated with individual mean MAP values and with the proportion of MAP values ≥85 mmHg upon the first 3 days (3d-MAP%≥85). Results: The initial AIS grades were A 29.4%, B 17.6%, C 31.4%, and D 21.6%. AIS grade improved in 24 patients (47.1%). During ICU care, 82.0% and 36.8% of the measured MAP values reached ≥85 mmHg in the higher and the lower MAP groups, respectively (p