Hemodynamic and Catecholamine Responses to Laryngoscopy and Tracheal Intubation in Patients with Complete Spinal Cord Injuries

Yoo, Kyung Yeon; Lee, Jong-Un; Kim, Hak S.; Im, Woong Mo

doi:10.1097/00000542-200109000-00017

Cited by 22 publications

(16 citation statements)

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“…In individuals with an intact spinal cord, stimulating the trachea elicits hypertension and tachycardia, a response dependent on supraspinal regulated sympathetic activity. By contrast, in patients with SCI, efferent cardiac parasympathetic nerve pathways remain intact while sympathetic regulation is impaired, which can cause unopposed vagal over-activity in response to tracheal stimulation, leading to bradycardia and cardiac arrest (373). The treatment of bradycardia with atropine to competitively antagonize cardiac muscarinic ACh receptors on target organs is only partially and transiently effective because of sympathetic deficiency.…”

Section: Cardiac Dysrhythmiasmentioning

confidence: 99%

Autonomic Consequences of Spinal Cord Injury

Hou

Rabchevsky

2014

Comprehensive Physiology

179

112

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Spinal cord injury (SCI) results not only in motor and sensory deficits but also in autonomic dysfunctions. The disruption of connections between higher brain centers and the spinal cord, or the impaired autonomic nervous system itself, manifests a broad range of autonomic abnormalities. This includes compromised cardiovascular, respiratory, urinary, gastrointestinal, thermoregulatory, and sexual activities. These disabilities evoke potentially life-threatening symptoms that severely interfere with the daily living of those with SCI. In particular, high thoracic or cervical SCI often causes disordered hemodynamics due to deregulated sympathetic outflow. Episodic hypertension associated with autonomic dysreflexia develops as a result of massive sympathetic discharge often triggered by unpleasant visceral or sensory stimuli below the injury level. In the pelvic floor, bladder and urethral dysfunctions are classified according to upper motor neuron versus lower motor neuron injuries; this is dependent on the level of lesion. Most impairments of the lower urinary tract manifest in two interrelated complications: bladder storage and emptying. Inadequate or excessive detrusor and sphincter functions as well as detrusor-sphincter dyssynergia are examples of micturition abnormalities stemming from SCI. Gastrointestinal motility disorders in spinal cord injured-individuals are comprised of gastric dilation, delayed gastric emptying, and diminished propulsive transit along the entire gastrointestinal tract. As a critical consequence of SCI, neurogenic bowel dysfunction exhibits constipation and/or incontinence. Thus, it is essential to recognize neural mechanisms and pathophysiology underlying various complications of autonomic dysfunctions after SCI. This overview provides both vital information for better understanding these disorders and guides to pursue novel therapeutic approaches to alleviate secondary complications.

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Section: Cardiac Dysrhythmiasmentioning

confidence: 99%

Autonomic Consequences of Spinal Cord Injury

Hou

Rabchevsky

2014

Comprehensive Physiology

179

112

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“…In the specific exposure category ( Table 3) the authors studied the response in HR to various stimuli including effects of exercise, penile vibro-stimulation, tracheal suction and intubation, facial water-immersion, and tilting in individuals with SCI. 8,15,16,[20][21][22][23][24][25][26] Claydon et al 15 reported that 6 of 13 male participants with cervical SCI developed new bradycardia when undergoing penile vibro-stimulation for sperm retrieval. Furthermore, some of these participants had episodes of atrial premature beats and VPB during or after the procedure.…”

Section: Specific Exposurementioning

confidence: 99%

Cardiac arrhythmias associated with spinal cord injury

Hector¹,

Biering‐Sørensen²,

Krassioukov³

et al. 2013

The Journal of Spinal Cord Medicine

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“…Patients with high-level paraplegia (T1-T4) were also excluded because they were few in number and they showed different haemodynamic and catecholamine responses from the other groups. 4 Neurological examinations were performed by the University Hospital Spine Center according to American Spinal Injury Association standards. 12 Motor function was examined by using key muscles for levels C5 to T1 and L2 to S1, and total paralysis of motor strength was regarded as a complete lesion.…”

Section: Methodsmentioning

confidence: 99%

“…Two hundred and fourteen patients with complete cord injury were studied. They were either quadriplegics (.C7, n¼71) or paraplegics (,T5, n¼143), and were subdivided into six groups each according to the time since injury: ,4 week (acute), 4 week-1 yr, 1-5, 5-10, 10 -20, and .20 yr. Twenty patients with no cord injury served as controls. Systolic arterial pressure (SAP), heart rate (HR), and plasma catecholamine concentrations were determined.…”

mentioning

confidence: 99%