Prospective Evaluation of 24 h/2 Days’ Monitoring of Systemic Blood Pressure in Patients with Traumatic Paraplegia – A Single-center Study

Abstract

Background: Cardiovascular dysfunction and cognitive decline are more common in traumatic spinal cord injury (SCI). Most of people with a cervical or upper-thoracic SCI usually experience orthostatic hypotension and autonomic dysreflexia, which are described by changes in systemic blood pressure (BP). Objectives: The objective of the study is to evaluate baseline heart rate (HR), baseline BP, and ambulatory arterial blood pressure monitoring (ABPM) in traumatic paraplegia patients. Materials and Methods: We enrolled 36 patients of traumatic paraplegia patients, paralyzed by Road traffic accident or fall from height within 7 days of trauma. Inclusion criteria were based on Asia Impairment Scale. The BP was monitored for 24 h/2 days and repeated on 12th day of first monitoring. Ambulatory BP was monitored by ABPM machine at ½ hourly from 6 am to 10 pm and 1 hourly from 10 pm to 6 am. The continuous variables were statistically analyzed and compared by t-test. Results: The night dipping (Systole) and morning surge (Systole) were significantly lower on 12th day as compared to within 7 days (P = 0.002) whereas the diurnal index (diastole) and diurnal index (mean arterial pressure) were comparable in between within 7 days and 12th day. The mean systolic BP (SBP) maximum and SBP minimum were significantly lower at 12th day as compared to within 7 days, whereas diastolic BP maximum and minimum were comparable in between within 7 days and at 12th day. The changes in minimum, maximum and mean double product (all, active periods, and passive periods) were not found statistically significant in between within 7 days and at 12th day. Conclusion: Traumatic paraplegic patients have altered diurnal index, morning surge, night dipping, and SBP on APBM monitoring.

Keywords

• blood pressure
• heart rate
• paraplegic
• spinal cord injury
• trauma