Document Detail

Acute changes in systemic hemodynamics and serum vasopressin after complete cervical spinal cord injury in piglets.
MedLine Citation:
PMID:  20458554     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Spinal cord injury (SCI) produces acute hemodynamic alterations through disruption of sympathetic output of the autonomic nervous system and places individuals with SCI at high risk of secondary ischemic insult to the spinal cord as well as to other organs. The purpose of this study was to examine hemodynamics and serum vasopressin concentration in the acute period following complete cervical SCI in piglets. METHODS: We developed a new model of traumatic complete cervical SCI in piglets and measured acute hemodynamic variables and serum arginine vasopressin (AVP) concentrations at baseline and for 4 h after SCI under fentanyl anesthesia. RESULTS: Complete cervical SCI caused an immediate tachycardia which lasted for approximately 1 h, immediate hypotension which was sustained for the 4-h duration of the study, decreases in both systemic and pulmonary vascular resistance, and a compensatory increase in cardiac output, which resulted initially from an increase in heart rate (HR) but was later sustained after resolution of tachycardia by an increase in cardiac stroke volume. Serum AVP concentration increased significantly after SCI and did not change in the control group. Neurogenic shock did not occur due to the robust increase in cardiac output and cardiac stroke volume. CONCLUSIONS: Complete cervical SCI produces hemodynamic alterations consistent with the withdrawal of sympathetic tone. Although mean arterial pressure (MAP) decreased significantly after SCI, the increase in serum vasopressin may have played a role in maintaining blood pressure and preventing circulatory collapse, a complication which is encountered frequently in patients with cervical and upper thoracic SCI.
Michael Zahra; Amer Samdani; Kurt Piggott; Manuel Gonzalez-Brito; Juan Solano; Roosevelt De Los Santo; Juan C Buitrago; Farid Alam; Dansha He; John P Gaughan; Randal Betz; Dalton Dietrich; John Kuluz
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Neurocritical care     Volume:  13     ISSN:  1556-0961     ISO Abbreviation:  Neurocrit Care     Publication Date:  2010 Aug 
Date Detail:
Created Date:  2010-07-05     Completed Date:  2010-10-14     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101156086     Medline TA:  Neurocrit Care     Country:  United States    
Other Details:
Languages:  eng     Pagination:  132-40     Citation Subset:  IM    
Saint Louis University School of Medicine, Saint Louis, MO, USA.
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MeSH Terms
Animals, Newborn
Arginine Vasopressin / blood*
Blood Pressure
Cardiac Output
Cervical Vertebrae
Heart Rate
Magnetic Resonance Imaging
Pulmonary Circulation
Spinal Cord / pathology
Spinal Cord Injuries / blood,  diagnosis,  physiopathology*
Stroke Volume
Time Factors
Vascular Resistance
Reg. No./Substance:
113-79-1/Arginine Vasopressin

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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