Journal article
Does mean arterial pressure augmentation improve neurological recovery of blunt spinal cord injuries: an EAST multicenter trial
Trauma surgery & acute care open, Vol.10(3), p.e001768
08/17/2025
DOI: 10.1136/tsaco-2025-001768
PMID: 40831772
Abstract
BackgroundTreatment of blunt traumatic spinal cord injuries (SCIs) often includes maintaining elevated mean arterial blood pressures (MAP) to enhance perfusion to the spinal cord. Optimal hyperperfusion protocols and treatment algorithms have yet to be delineated due to a paucity of large volume prospective studies. This study aims to identify predictors of neurological improvement in American Spinal Injury Association (ASIA) impairment score following blunt SCI.Study designProspective (January 10, 2021 to June 1, 2023) multicenter study included blunt SCI patients age >18 with complete neurological examination documented on hospital arrival. Patients were divided into two groups: neurological improvement and no improvement, based on their change in ASIA score from arrival to hospital discharge.ResultsA total of 19 centers contributed 222 patients of those, 164 had pre-ASIA and post-ASIA scores. The ASIA improvement group had 36 patients (22%). There was no statistical difference in the median percentage of time patients spent at a MAP >85 mm Hg during treatment 80.7% (IQR 63.6, 93.4) no improvement vs 83.6% (IQR 70.1, 93.0) in the improvement, (p=0.87). There was no difference in the median duration of MAP treatment in hours between the groups (95.6 hours (IQR 62.55, 113.48) in the no improvement group versus 96 (IQR 72, 113.5) (p=0.40) in the improvement group).ConclusionsOverall, 22% of all blunt SCI patients saw an improvement in their ASIA score. Adherence to and length of MAP augmentation was not a statistically significantly different between groups.Level of evidenceLevel IV Therapeutic/Care Management.
Details
- Title: Subtitle
- Does mean arterial pressure augmentation improve neurological recovery of blunt spinal cord injuries: an EAST multicenter trial
- Creators
- Aimee LaRiccia - OhioHealthStephanie Doris - OhioHealthBhairav Shah - OhioHealthTanisha Kashikar - OhioHealthErik Teicher - Inova Fairfax HospitalLindsey Perea - Lancaster General HospitalJennifer Huber - Lancaster General HospitalMalia Eischen - Queen's Medical CenterH Akin Erol - Queen's Medical CenterMichael Steven Farrell - San Francisco General HospitalLauren Colom - Lehigh Valley Health NetworkStephanie Scott - University of Tennessee Medical CenterBrian Daley - University of Tennessee Medical CenterJames Bardes - West Virginia UniversityGregory Schaefer - West Virginia UniversityMelissa Moncrief - Kettering Medical CenterWilliam DeVoe - Riverside Methodist HospitalRyan Peter Dumas - The University of Texas Southwestern Medical CenterCaitlin Anne Fitzgerald - East Carolina UniversityWilliam Brigode - Cook County Health and Hospitals SystemJohn D Berne - Broward Health Medical CenterDalier R Mederos - Broward HealthScott Armen - Pennsylvania State UniversityMelissa Linskey Dougherty - Pennsylvania State UniversityAsanthi Ratnasekera - Christiana Care Health SystemEmily Alberto - Christiana Care Health SystemAlison Smith - Louisiana State UniversityBradley M Dennis - Vanderbilt University Medical CenterStephen Gadomski - Vanderbilt University Medical CenterJeffry Nahmias - UC Irvine HealthClaudia Alvarez - University of California, IrvineSalina Wydo - Cooper University HospitalJennifer Schweinsburg - Cooper University HospitalCarlos H Palacio - South Texas Health System, Edinburg, Texas, USAM Chance Spalding - Mount Carmel HealthJoshua Hill - OhioHealth
- Resource Type
- Journal article
- Publication Details
- Trauma surgery & acute care open, Vol.10(3), p.e001768
- DOI
- 10.1136/tsaco-2025-001768
- PMID
- 40831772
- NLM abbreviation
- Trauma Surg Acute Care Open
- ISSN
- 2397-5776
- eISSN
- 2397-5776
- Publisher
- BMJ Publishing Group Ltd
- Language
- English
- Date published
- 08/17/2025
- Academic Unit
- Surgery
- Record Identifier
- 9985243566502771
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