TY - JOUR
T1 - Bet 1
T2 - Can induced hypertension improve outcome following acute traumatic spinal cord injury?
AU - Bertram-Ralph, Elliott
AU - Horner, Daniel
N1 - © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.
PY - 2018/4
Y1 - 2018/4
N2 - A shortcut review was carried out to establish whether augmentation of blood pressure to a high mean arterial pressure (MAP) target in the early phase of traumatic spinal cord injury (SCI) could lead to improvements in morbidity or mortality. 23 directly relevant papers were found using the reported search strategy. Of these, two systematic reviews collated the best evidence to answer the clinical question. The author, date and country of publication; patient group studied; study type; relevant outcomes; results and study weaknesses of the best papers are tabulated. It is concluded that data from observational cohort studies support high MAP targets and avoidance of hypotension in the early stages of traumatic SCI, but there are insufficient trial data to support routine use as best practice. Given the intervention carries risk, induced hypertension requires careful consideration on a case-by-case basis.
AB - A shortcut review was carried out to establish whether augmentation of blood pressure to a high mean arterial pressure (MAP) target in the early phase of traumatic spinal cord injury (SCI) could lead to improvements in morbidity or mortality. 23 directly relevant papers were found using the reported search strategy. Of these, two systematic reviews collated the best evidence to answer the clinical question. The author, date and country of publication; patient group studied; study type; relevant outcomes; results and study weaknesses of the best papers are tabulated. It is concluded that data from observational cohort studies support high MAP targets and avoidance of hypotension in the early stages of traumatic SCI, but there are insufficient trial data to support routine use as best practice. Given the intervention carries risk, induced hypertension requires careful consideration on a case-by-case basis.
KW - Arterial Pressure/physiology
KW - Evidence-Based Emergency Medicine/methods
KW - Humans
KW - Hypertension/etiology
KW - Hypotension/drug therapy
KW - Monitoring, Physiologic/methods
KW - Spinal Cord Injuries/drug therapy
U2 - 10.1136/emermed-2018-207608.2
DO - 10.1136/emermed-2018-207608.2
M3 - Review article
C2 - 29559542
SN - 1472-0205
VL - 35
SP - 270
EP - 272
JO - Emergency medicine journal : EMJ
JF - Emergency medicine journal : EMJ
IS - 4
ER -