| Altered cardiovascular responses to tracheal intubation in patients with complete spinal cord injury: relation to time course and affected level. | |
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MedLine Citation:
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PMID: 20923869 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: We determined cardiovascular responses to tracheal intubation in relation to the time since injury in patients with different levels of spinal cord injury. METHODS: Two hundred and fourteen patients with complete cord injury were studied. They were either quadriplegics (>C7, n=71) or paraplegics (<T5, n=143), 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. RESULTS: Intubation did not affect SAP in the quadriplegics regardless of the time post-injury, but it significantly increased SAP in all paraplegics. Moreover, the pressor response was enhanced in the paraplegics who were 10 yr or more since injury (P<0.05). HR increased significantly in all groups; the magnitude of the increase was less only in acute quadriplegics compared with controls. Plasma concentrations of norepinephrine increased in every group except for the quadriplegics within 4 weeks of injury. The maximum increases in SAP, HR, and norepinephrine from awake baseline values were smaller in the quadriplegics than in the paraplegics (P<0.01). CONCLUSIONS: The cardiovascular and catecholamine responses to intubation change as a function of the time elapsed and the level of the cord injury. In this study, the pressor response to tracheal intubation was abolished in the quadriplegics but not in paraplegics; indeed, it was enhanced at 10 yr or more since injury in this group. |
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Authors:
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K Y Yoo; C W Jeong; S J Kim; S T Jeong; S H Kwak; M H Shin; J Lee |
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Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't Date: 2010-10-05 |
Journal Detail:
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Title: British journal of anaesthesia Volume: 105 ISSN: 1471-6771 ISO Abbreviation: Br J Anaesth Publication Date: 2010 Dec |
Date Detail:
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Created Date: 2010-11-18 Completed Date: 2010-12-13 Revised Date: 2011-03-16 |
Medline Journal Info:
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Nlm Unique ID: 0372541 Medline TA: Br J Anaesth Country: England |
Other Details:
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Languages: eng Pagination: 753-9 Citation Subset: IM |
Affiliation:
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Department of Anaesthesiology and Pain Medicine, Chonnam National University Medical School, 8 Hak-dong, Gwangju 501-190, Republic of Korea. kyyoo@jnu.ac.kr |
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Anesthesia, General Arrhythmias, Cardiac / etiology Blood Pressure / physiology* Epinephrine / blood Female Heart Rate / physiology* Humans Hypertension / etiology Intraoperative Complications Intubation, Intratracheal* / adverse effects Laryngoscopy Male Middle Aged Norepinephrine / blood Paraplegia / etiology, physiopathology Quadriplegia / etiology, physiopathology Spinal Cord Injuries / complications, physiopathology* Time Factors Young Adult |
| Chemical | |
Reg. No./Substance:
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51-41-2/Norepinephrine; 51-43-4/Epinephrine |
| Comments/Corrections | |
Comment In:
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Br J Anaesth. 2011 Mar;106(3):417-8; author reply 418
[PMID:
21317230
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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