Iris Leister / Adam Ferguson, Spinal Cord Injury Center, Clinical Research Unit, BG Trauma Center Murnau, Murnau, Germany

Early predictors for neurological outcome

Funded in: 2022, 2023, 2024

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Problem: Treatment currently not specific to age, injury severity and medical history
Target: Blood pressure monitoring and pharmacological interventions for neurological recovery
Goal: Improve treatment with individualized blood pressure targets

Acute traumatic spinal cord injury (SCI) is often accompanied by severe concomitant injuries and treatment in the early stages after injury is extremely challenging. Previous studies have postulated that blood pressure is strongly related to spinal cord blood flow and might thereby affect neurological recovery after SCI. Guidelines recommend arterial blood pressure monitoring and augmentation targeting a certain pressure for the first days after injury. To achieve these blood pressure targets, vasopressor medication is being introduced, although vasopressor administration poses a substantial risk for several adverse side effects. This is especially problematic in individuals with acute SCI, where various other medications are being administered at the same time.

Problem statement
In the opinion of the researchers the benefit of blood pressure augmentation to a certain pre-defined target needs to be re-evaluated and blood pressure targets should be specific to a patient’s age, injury severity, and medical history.

The neuroscientists will retrospectively analyze routinely collected data from patients who sustained traumatic SCI and were treated in the intensive care unit at the BG Trauma Center Murnau, Germany. In the first step, they aim to investigate the effect of blood pressure monitoring, vasopressor administration, and other pharmacological interventions on neurological recovery. In a second step of analysis, the researchers will evaluate if new biomarkers can be derived from routinely collected data in the very early post-injury phase.

Expected results
The scientists anticipate that a better understanding of the relation between early interventions during intensive care and neurological recovery.

Potential application
Ideally, the analysis will allow the researchers to define blood pressure targets specific to the individual patient situation. Together with an identification of potential new biomarkers, this will inform clinical decision-making in the future and would therefore ultimately improve the treatment of acute SCI.