A prospective multi-center study comparing the complication profile of modest systemic hypothermia versus normothermia for acute cervical spinal cord injury

Vedantam, Aditya; Jimsheleishvili, George; Alberga, Linda; Ahmad, Faiz U.; Murphy, Rory K.J.; Jackson, J. Benjamin; Rodgers, Richard B.; Levi, Allan D.

doi:10.1038/s41393-021-00747-w

Cited by 6 publications

(7 citation statements)

References 23 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…32 Furthermore, a recent prospective multicenter study showed that modest systemic hypothermia was not associated with an increased risk of complications after SCI. 38 A clinical trial on systemic hypothermia (33°C for 48 hours) following acute SCI ( ≤ 24 hours) is cur-rently underway. 38 This meta-analysis has some limitations.…”

Section: Discussionmentioning

confidence: 99%

“…38 A clinical trial on systemic hypothermia (33°C for 48 hours) following acute SCI ( ≤ 24 hours) is cur-rently underway. 38 This meta-analysis has some limitations. First, the number of included studies was few, and the number of included patients was small.…”

Section: Discussionmentioning

confidence: 99%

“…However, modest systemic hypothermia (32°C–34°C) provides the benefits of hypothermia without additional significant morbidity associated with deep systemic hypothermia [ 32 ]. Furthermore, a recent prospective multicenter study showed that modest systemic hypothermia was not associated with an increased risk of complications after SCI [ 38 ]. A clinical trial on systemic hypothermia (33°C for 48 hours) following acute SCI (≤ 24 hours) is currently underway [ 38 ].…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Meta-Analysis on the Effect of Hypothermia in Acute Spinal Cord Injury

et al. 2022

View full text Add to dashboard Cite

Objective: Acute spinal cord injury (SCI) can result in debilitating motor, sensory, and autonomic dysfunction. As a treatment option, therapeutic hypothermia has been researched to inadequate pharmaceutical treatment, except for methylprednisolone. In this article, we systematically meta-analyzed to clarify the effect of hypothermia in acute SCI on neurological outcomes.Methods: The PubMed, Embase, Web of Science, and Cochrane clinical trial databases were systematically searched until June 30, 2022. The proportion of cases with improved neurological status after hypothermia in acute SCI were pooled with a random-effects model. Subgroup analyses for the method of hypothermia and injury level were conducted.Results: Eight studies with a total of 103 patients were included. Hypothermia in acute SCI improved neurological function by 55.8% (95% confidence interval [CI]: 39.4%–72.1%). The subgroup analysis revealed that the pooled proportion of cases showing neurological improvement was higher with systemic hypothermia (70.9%) (95% CI, 14.9%–100%) than with local hypothermia (52.5%) (95% CI, 40.4%–64.5%), although the subgroup difference was not statistically significant (p = 0.53). Another subgroup analysis revealed that the proportion of cases with neurological improvement did not differ statistically between the cervical spine (61.4%) (95% CI, 42.2%–80.6%) and thoracic spine injury groups (59.4%) (95% CI, 34.8%–84.0%) (p = 0.90).Conclusion: This meta-analysis identified that more than 50% of patients showed neurological improvement after hypothermia following acute SCI in general. A multicenter, randomized, double-blind study with larger sample size is necessary to validate the findings further.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Meta-Analysis on the Effect of Hypothermia in Acute Spinal Cord Injury

et al. 2022

View full text Add to dashboard Cite

show abstract

“…Preliminary results found no increased risk of overall, pulmonary, or thromboembolic complications. 37 This prospective study is still recruiting and may shed additional insight into the risk-benefit ratio for hypothermia induction after ASCI.…”

Section: Other Investigational Modalitiesmentioning

confidence: 99%

Updates in the Early Management of Acute Spinal Cord Injury

Lambrechts

Issa

Hilibrand

2023

J Am Acad Orthop Surg

View full text Add to dashboard Cite

Spinal cord injury (SCI) is a leading cause of disability worldwide, and effective management is necessary to improve clinical outcomes. Many long-standing therapies including early reduction and spinal cord decompression, methylprednisolone administration, and optimization of spinal cord perfusion have been around for decades; however, their efficacy has remained controversial because of limited high-quality data. This review article highlights studies surrounding the role of early surgical decompression and its role in relieving mechanical pressure on the microvascular circulation thereby reducing intraspinal pressure. Furthermore, the article touches on the current role of methylprednisolone and identifies promising studies evaluating neuroprotective and neuroregenerative agents. Finally, this article outlines the expanding body of literature evaluating mean arterial pressure goals, cerebrospinal fluid drainage, and expansive duroplasty to further optimize vascularization to the spinal cord. Overall, this review aims to highlight evidence for SCI treatments and ongoing trials that may markedly affect SCI care in the near future.

show abstract

“…The logistical intensity of acute SCI critical care has facilitated several clinical trials of neuroprotection [ 28 ]. The first attempts at neuroprotection were based on hypothermia and continue to this day [ 29 , 30 , 31 , 32 , 33 , 34 ].…”

Section: Primary and Secondary Injury To The Spinal Cordmentioning

confidence: 99%

Pathophysiology, Classification and Comorbidities after Traumatic Spinal Cord Injury

Guest

Datta

Jimsheleishvili

et al. 2022

JPM

Self Cite

View full text Add to dashboard Cite

The spinal cord is a conduit within the central nervous system (CNS) that provides ongoing communication between the brain and the rest of the body, conveying complex sensory and motor information necessary for safety, movement, reflexes, and optimization of autonomic function. After a spinal cord injury (SCI), supraspinal influences on the spinal segmental control system and autonomic nervous system (ANS) are disrupted, leading to spastic paralysis, pain and dysesthesia, sympathetic blunting and parasympathetic dominance resulting in cardiac dysrhythmias, systemic hypotension, bronchoconstriction, copious respiratory secretions and uncontrolled bowel, bladder, and sexual dysfunction. This article outlines the pathophysiology of traumatic SCI, current and emerging methods of classification, and its influence on sensory/motor function, and introduces the probable comorbidities associated with SCI that will be discussed in more detail in the accompanying manuscripts of this special issue.

show abstract

A prospective multi-center study comparing the complication profile of modest systemic hypothermia versus normothermia for acute cervical spinal cord injury

Cited by 6 publications

References 23 publications

Meta-Analysis on the Effect of Hypothermia in Acute Spinal Cord Injury

Meta-Analysis on the Effect of Hypothermia in Acute Spinal Cord Injury

Updates in the Early Management of Acute Spinal Cord Injury

Pathophysiology, Classification and Comorbidities after Traumatic Spinal Cord Injury

Contact Info

Product

Resources

About