TRAUMA SURGERY 

Journal of Neurosurgical Sciences 2013 December;57(4):281-92

Copyright © 2013 EDIZIONI MINERVA MEDICA

language: English

Critical care management of patients with acute spinal cord injury

Lo V. ¹, Esquenazi Y. ¹, Han M. K. ², Lee K. ¹ ✉

¹ Department of Neurosurgery University of Texas Health Science Center at Houston Medical School, Houston, TX, USA; ² Department of Neurology Seoul National University Boondang Hospital, Seoul, Korea

Spinal cord injury (SCI) inevitably extends beyond neurologic consequences. The relationship between the spinal cord and its control of other organ systems make SCI management complex, requiring treatment on a multisystem approach. Patients frequently have hemodynamic instability and respiratory insufficiency secondary to the neurologic insult. Rigorous monitoring and anticipation of potential complications are essential in managing SCI, requiring a level of care provided in a neurocritical care unit. This review covers the pathophysiology, initial assessment, and stabilization in addition to acute management of cardiovascular and respiratory issues following SCI. Subsequent potential complications of deep vein thrombosis, gastrointestinal, and urinary systems and their management in the critical care setting are also addressed in this review.