Citation

Saadoun S, Papadopoulos MC. Crit. Care 2016; 20(1): e308.

Affiliation

Academic Neurosurgery Unit, St. George's, University of London, Cranmer Terrace, Tooting, London, SW17 0RE, UK. mpapadop@sgul.ac.uk.

Copyright

(Copyright © 2016, Holtzbrinck Springer Nature Publishing Group - BMC)

DOI

10.1186/s13054-016-1490-3

PMID

27716379

Abstract

This paper challenges the current management of acute traumatic spinal cord injury based on our experience with monitoring from the injury site in the neurointensive care unit. We argue that the concept of bony decompression is inadequate. The concept of optimum spinal cord perfusion pressure, which differs between patients, is introduced. Such variability suggests individualized patient treatment. Failing to optimize spinal cord perfusion limits the entry of systemically administered drugs into the injured cord. We conclude that monitoring from the injury site helps optimize management and should be subjected to a trial to determine whether it improves outcome.

Language: en