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Monitoring Spinal Cord Tissue Oxygen in Patients With Acute, Severe Traumatic Spinal Cord Injuries

By Currents Editor posted 02-15-2022 09:52


Monitoring Spinal Cord Tissue Oxygen in Patients With Acute, Severe Traumatic Spinal Cord Injuries

Critical Care Medicine (01/06/22) DOI: 10.1097/CCM.0000000000005433

Visagan, Ravindran; Hogg, Florence R.A.; Gallagher, Mathew J.; et al.

A recent study investigated whether monitoring tissue oxygen tension from the injury site (psctO2) in patients with acute, severe traumatic spinal cord injuries is feasible. The study involved 26 patients with traumatic spinal cord injuries, American spinal injury association Impairment Scale A-C. To monitor intraspinal pressure (ISP), spinal cord perfusion pressure (SCPP), tissue glucose, lactate/pyruvate ratio (LPR), and psctO2, the researchers inserted at the injury site a pressure probe, a microdialysis catheter and an oxygen electrode within 72 hours of injury, for up to a week. Based on 2,213 hours of data, and 6-28 months of follow-up, the researchers found that psctO2 was significantly affected by several factors: ISP, SCPP, tissue glucose, tissue LPR, and fever. However, tissue hypoxia also occurred independently. Raising the FIO2 by 0.48 increased psctO2 by 71.8% over baseline within 8.4 minutes. Changes in psctO2 correlated with changes in limb motor score for patients with motor-incomplete injuries. For those with motor-complete outcomes, the injured cord spent 11% (39%) at psctO2 less than 5 mm Hg, compared with 1% (30%) at psctO2 less than 5 mm Hg for individuals with motor-incomplete outcomes. Five patients experienced cerebrospinal fluid leak, while one had a wound become infected. The findings serve as "the foundation for measuring and altering spinal cord oxygen at the injury site," the authors write, though additional research is needed.


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