Treatment of Orthostatic Hypotension During Acute Inpatient Rehabilitation After Spinal Cord Injury: Usual Care vs. Anti-hypotensive Therapy.

IF 4.3 3区 材料科学 Q1 ENGINEERING, ELECTRICAL & ELECTRONIC
Jill M Wecht, Joseph P Weir, Vincent Huang, Miguel X Escalon, Thomas N Bryce
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Abstract

Background: To compare the pharmacological treatment of hypotension and orthostatic hypotension (OH) initiated based upon a blood pressure (BP) threshold, regardless of symptoms (TXT), to usual care pharmacological treatment of symptomatic hypotension (UC), during acute inpatient rehabilitation (AIR) following spinal cord injury (SCI).

Methods: Block randomization, based on the neurological level of injury as: cervical lesions (C1-C8); high thoracic lesions (T1-T5), and low thoracic lesions (T6-T12), was used to determine responses to the primary question "was the therapy session affected by low BP or concern for low BP development?" Study participants and therapists were unaware of the group assignment.

Results: A total of 66 participants enrolled; 25 (38%) in the TXT group, 29 (44%) in the UC group, and 12 (18%) withdrew. Responses to the primary question were recorded for 32 participants, 15 in the TXT, and 17 in the UC group. There was an average of 81 ± 51 therapy sessions/participant in the TXT and 60 ± 27 sessions/participant in the UC group. Of those therapy sessions, low BP or concerns for low BP affected an average of 9 ± 8 sessions/participant in the TXT group and 10 ± 12 sessions/participant in the UC group. Neither the total number of therapy sessions (P = 0.16) nor group assignment (P = 0.83) significantly predicted the number of sessions affected by low BP.

Conclusions: These data are not conclusive but indicate that the treatment of asymptomatic hypotension and OH does not increase time spent in therapy compared to UC treatment of symptomatic hypotension and OH in newly injured patients with SCI.

Clinical trials registration: #NCT02919917.

脊髓损伤后急性住院康复期间的直立性低血压治疗:常规护理与抗高血压治疗。
背景:目的:比较脊髓损伤(SCI)后急性住院康复(AIR)期间根据血压(BP)阈值(无论症状如何)启动的低血压和正张性低血压(OH)药物治疗(TXT)与症状性低血压(UC)常规药物治疗(AIR):方法:根据损伤的神经水平(颈椎损伤(C1-C8)、胸椎高位损伤(T1-T5)和胸椎低位损伤(T6-T12))进行分块随机化,以确定对主要问题 "治疗过程是否受到低血压或对低血压发展的担忧的影响?研究参与者和治疗师均不知道分组情况:共有 66 名参与者参加了研究,其中 TXT 组 25 人(38%),UC 组 29 人(44%),12 人(18%)退出。记录了 32 名参与者对主要问题的回答,其中 TXT 组 15 人,UC 组 17 人。TXT组平均每名参与者接受了81±51次治疗,UC组平均每名参与者接受了60±27次治疗。在这些治疗过程中,血压低或对血压低的担忧平均影响了 TXT 组(9±8 次/参与者)和 UC 组(10±12 次/参与者)。治疗疗程总数(p=0.16)和组别分配(p=0.83)都不能显著预测受低血压影响的疗程数:这些数据并不具有决定性,但表明,与对新近受伤的 SCI 患者进行症状性低血压和 OH 的常规治疗相比,治疗无症状性低血压和 OH 不会增加患者的治疗时间。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
7.20
自引率
4.30%
发文量
567
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