Abstract
Introduction
Due the impact of maturation on cardiovascular hemodynamics the degree of cardiovascular dysfunction, attributable to spinal cord injury (SCI), in the pediatric and adolescent population remains unclear. While few studies have begun to assess this, there is still a void in the literature regarding the prevalence of cardiovascular dysfunction and how best to identify and treat it in this population.
Case presentation
The purpose of this case series is to present the cardiovascular profile of three adolescent patients with chronic SCI, ages 14–16, following 2 or 3 days of 24-h Ambulatory Blood Pressure Monitoring (ABPM).
Discussion
We found that there are variations across the different cases in most cardiovascular hemodynamic categories and a clarification of the International Standards to document remaining Autonomic Function after Spinal Cord Injury (ISAFSCI) may be needed to accurately identify the remaining autonomic cardiovascular function in the adolescent SCI population.
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References
Wecht JM, Bauman WA. Decentralized cardiovascular autonomic control and cognitive deficits in persons with spinal cord injury. J Spinal Cord Med. 2013;36:74–81. http://www.ncbi.nlm.nih.gov/pubmed/23809520.
Wessely S, Nickson J, Cox B. Symptoms of low blood pressure: a population study. BMJ. 1990;301:362–5.
Illman A, Stiller K, Williams M. The prevalence of orthostatic hypotension during physiotherapy treatment in patients with an acute spinal cord injury. Spinal Cord. 2000;38:741–7.
Jegede AB, Rosado-Rivera D, Bauman WA, Cardozo CP, Sano M, Moyer JM, et al. Cognitive performance in hypotensive persons with spinal cord injury. Clin Auton Res. 2010;20:3–9. http://www.ncbi.nlm.nih.gov/pubmed/19842013.
Frisbie JH. Unstable baseline blood pressure in chronic tetraplegia. Spinal Cord. 2007;45:92–95. http://www.ncbi.nlm.nih.gov/pubmed/16568144.
Rosado-Rivera D, Radulovic M, Handrakis JP, Cirnigliaro CM, Jensen AM, Kirshblum S, et al. Comparison of 24-hour cardiovascular and autonomic function in paraplegia, tetraplegia, and control groups: implications for cardiovascular risk. J Spinal Cord Med. 2011;34:395-403. http://www.ncbi.nlm.nih.gov/pubmed/21903013.
Seabra-Garcez JD, Matos-Souza JR, Goulart D, Pithon KR, Abib E, Etchebehere M, et al. Ambulatory blood pressure is associated with subclinical atherosclerosis in spinal cord injury subjects. Int J Cardiol. 2012;154:89–90. http://www.ncbi.nlm.nih.gov/pubmed/22062895.
Hwang M, Zebracki K, Betz RR, Mulcahey MJ, Vogel LC. Normative blood pressure and heart rate in pediatric spinal cord injury. Top Spinal Cord Inj Rehabil. 2013;19:87–95. http://www.ncbi.nlm.nih.gov/pubmed/23671378.
Zebracki K, Hwang M, Patt PL, Vogel LC. Autonomic cardiovascular dysfunction and vitamin D deficiency in pediatric spinal cord injury. J Pediatr Rehabil Med. 2013;6:45–52. http://www.ncbi.nlm.nih.gov/pubmed/23481891.
WHO. Spinal cord injury. www.who.int/mediacentre/factsheets/fs384/en/. Updated 2013. Accessed 22 Aug 2014.
Gillman MW, Cook NR. Blood pressure measurement in childhood epidemiological studies. Circulation. 1995;92:1049–57. http://www.ncbi.nlm.nih.gov/pubmed/7641339.
Lurbe E, Thijs L, Redon J, Alvarez V, Tacons J, Staessen J. Diurnal blood pressure curve in children and adolescents. J Hypertens. 1996;14:41–46. http://www.ncbi.nlm.nih.gov/pubmed/12013493.
Hubli M, Krassioukov AV. Ambulatory blood pressure monitoring in spinal cord injury: clinical practicability. J Neurotrauma. 2014;31:789–97. http://www.ncbi.nlm.nih.gov/pubmed/24175653.
O’Sullivan JJ, Derrick G, Griggs P, Foxall R, Aitkin M, Wren C. Ambulatory blood pressure in school children. Arch Dis Child. 1999;80:529–32. http://www.ncbi.nlm.nih.gov/pubmed/10332001.
Khan IA, Gajaria M, Stephens D, Balfe JW. Ambulatory blood pressure monitoring in children: a large center’s experience. Pediatr Nephrol. 2000;14:802–5. http://www.ncbi.nlm.nih.gov/pubmed/10955931.
Varda NM, Gregoric A. Twenty-four-hour ambulatory blood pressure monitoring in infants and toddlers. Pediatr Nephrol. 2005;20:798–802. http://www.ncbi.nlm.nih.gov/pubmed/15856318.
Krassioukov A, Biering-Sorensen F, Donovan W, Kennelly M, Kirshblum S, Krough K, et al. International standards to document remaining autonomic function after spinal cord injury. J Spinal Cord Med. 2012;35:201–10. https://doi.org/10.1179/1079026812Z.00000000053.
Flynn JT, Kaelber DC, Baker-Smith CM, Blowery D, Carroll A, Stephan DR, et al. Clinical practice guideline for screening and management of high blood pressure in children and adolescents. Pediatrics 2017;140:e20171904.
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Krisa, L., Vogel, L.C. & Wecht, J.M. Use of ambulatory blood pressure monitoring in adolescents with SCI: a case series. Spinal Cord Ser Cases 3, 17095 (2017). https://doi.org/10.1038/s41394-017-0034-7
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DOI: https://doi.org/10.1038/s41394-017-0034-7


