Impact of mean arterial blood pressure during the first seven days post spinal cord injury

Abstract

Purpose: To examine neurological outcomes in individuals with spinal cord injury (SCI) in relation to mean arterial blood pressure (MAP) during the first 7 days post injury. Method: The charts of individuals with complete tetraplegia (N = 17) admitted directly to Santa Clara Valley Medical Center from 2000 to 2006 were reviewed for MAP values and clinical results, including ASIA motor scores. Results: The percent of time spent with a MAP of ≤70 mm Hg was inversely correlated to motor score gains (R = .505, p < .05). After accounting for injury severity, the percent of time spent at a MAP ≤70 mm Hg accounted for 30% of variability in motor score gains. The correlation was insignificant for time spent at a MAP of ≥75 mm Hg. Conclusion: MAP values of ≤70 mm Hg were associated with lower gains in motor score. There was no significant correlation with neurologic outcomes and percent of time MAP values ≥75 mm Hg. This suggests that the current recommendation of maintaining MAP at 85-90 mm Hg for the first 7 days following acute SCI may not be appropriate given the lack of evidence of correlation with outcome. Future studies should be conducted to determine the optimal blood pressure to maximize neurological outcomes for patients with acute SCI. © 2010 Thomas Land Publishers, Inc.