Blood Volume and Hemoglobin After Spinal Cord Injury

Houtman, S.; Oeseburg, B.; Hopman, Maria T. E.

doi:10.1097/00002060-200005000-00008

Cited by 45 publications

(38 citation statements)

References 21 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…20 Taking the first consideration, total water per body weight in the spinal cord injured subject is reportedly comparable to controls, but intracellular volume is diminished and extracellular volume is expanded (although intravascular volume is constricted). 17,21,22 Furthermore, the intracellular volume is more constricted in the tetraplegic than in the paraplegic subject, thus coinciding with the polydipsia of higher levels of paralysis in the current survey. The first mechanism, thirst induced by diminished intracellular volume, may apply to the spinal cord injured subject.…”

Section: Discussionsupporting

confidence: 50%

See 1 more Smart Citation

Salt wasting, hypotension, polydipsia, and hyponatremia and the level of spinal cord injury

Frisbie

2006

Spinal Cord

View full text Add to dashboard Cite

Study Design: Case control. Objective: To test the reported correlation of hypotension, polydipsia, and hyponatremia with higher levels of spinal cord injury (SCI). Setting: A Veterans Administration Hospital, USA. Methods: The records of men who were paralyzed owing to trauma at any spinal cord level with motor complete lesions (ASIA A or B) and who received an annual physical and laboratory examination were reviewed for age, duration of paralysis, level of paralysis, blood pressure (BP), serum sodium, and 24 h urinary volume, creatinine, and sodium. Creatinine clearance and fractional excretion of sodium (FcNa) were calculated. Spearman rank-order correlations (r s ) were carried out. Results: Patients were aged 25 to 88 years, median 56 years, paralyzed 2-61 years, median 26 years, with levels of paralysis ranging from C2 to L4, median T4, n ¼ 111. From lower to higher levels of paralysis FcNa increased (0.4-7.3%), mean BP diminished (132-66 mmHg), urine volume increased (600-5400 ml), and serum sodium was reduced (148-129 mEq/l) -r s ¼ 0.29, 0.49, À0.22, and 0.23, respectively. Increasing 24 h urinary volumes correlated with lower serum sodium concentrations but higher creatinine clearance, r s ¼ À0.28, 0.24. Increasing 24 h urinary sodium improved creatinine clearance, r s ¼ 0.37. P-values ranged from o0.05 to o0.001. Conclusion: Higher levels of SCI correlate with reduced sodium conservation, hypotension, polydipsia, and hyponatremia. Greater water intake raises creatinine clearance but lowers serum sodium. Greater salt intake increases creatinine clearance.

show abstract

Section: Discussionsupporting

confidence: 50%

“…16 Fifth, intravascular volume is diminished. 17 This reduction is explainable by the reported leakage of osmotically active material, albumin, from the intravascular space, greater at higher levels of paralysis. 18 The relative importance of these factors on the protection of the circulation against gravity is uncertain.…”

Section: Discussionmentioning

confidence: 99%

Salt wasting, hypotension, polydipsia, and hyponatremia and the level of spinal cord injury

Frisbie

2006

Spinal Cord

View full text Add to dashboard Cite

show abstract

“…Acute alterations are mediated primarily by changes in sympathetic activity to the smooth muscle, whereas chronic changes are mediated primarily by changes in blood flow and pressure, which alters shear stress and consequently the number of smooth muscle cells in vessel walls. 48 Remodeling of peripheral arteries in paralyzed limbs occurs soon after SCI; within weeks there is a significant reduction in systemic blood volume 49 and a consequent inward remodeling of the arterial wall, 50 such that the diameter of the common femoral artery is 30-50% smaller [51][52][53][54] and resting blood flow in the leg is 30-40% lower than in AB individuals. 54,55 Compared with the inactive lower limbs, the active upper limb vasculature is relatively well preserved.…”

Section: Conduit Arterial Function After Sci Structural Adaptationsmentioning

confidence: 99%

Peripheral vascular function in spinal cord injury: a systematic review

et al. 2012

View full text Add to dashboard Cite

Background: During the past 20 years, significant advances in patient care have resulted in individuals with spinal cord injury (SCI) living longer than before. As lifespan increases, cardiovascular complications are emerging as the leading cause of mortality in this population, and individuals with SCI develop cardiovascular disease at younger ages than their able-bodied counterparts. To address this increasing clinical challenge, several recent studies investigated the central cardiovascular adaptations that occur following SCI. However, a somewhat less recognized component of cardiovascular dysfunction in this population is the peripheral vascular adaptations that also occur as a result of SCI. Study design: Literature review.Objective: To present a comprehensive overview of changes in arterial structure and function, which occur after SCI. Setting: Canada. Methods: A systematic literature review was conducted to extract studies that incorporated measures of arterial structure or function after SCI in animals or humans. Results: Individuals with SCI exhibit vascular dysfunction below the lesion that is characterized by a reduction in conduit artery diameter and blood flow, increased shear rate and leg vascular resistance, and adrenoceptor hyper-responsiveness. There is also recent alarming evidence for central arterial stiffening in individuals with SCI. Conclusion: Although physical deconditioning is the primary candidate responsible for the maladaptive remodeling of the peripheral vasculature after SCI, there is emerging evidence that blood pressure oscillations, such as those occurring in the large majority of individuals with SCI, also exacerbates vascular dysfunction in this population.

show abstract

“…33 There is only limited information available on circulating volume following SCI; however, it has also been shown that total blood volume and hemoglobin mass are decreased in individuals with SCI with a lesion above T4. 34 The combination of increased antidiuretic hormone secretion, low sodium intake, high sodium excretion and resultant hyponatremia are likely to predispose toward lower plasma volumes in patients with SCI. This, in turn, would exacerbate episodes of orthostatic hypotension in these individuals.…”

Section: (Figures Reprinted With Permission)mentioning

confidence: 99%

Challenges, concerns and common problems: physiological consequences of spinal cord injury and microgravity

et al. 2010

View full text Add to dashboard Cite

Introduction: Similarities between the clinical presentation of individuals living with spinal cord injury (SCI) and astronauts are remarkable, and may be of great interest to clinicians and scientists alike. Objectives: The primary purpose of this review is to outline the manner in which cardiovascular, musculoskeletal, renal, immune and sensory motor systems are affected by microgravity and SCI. Methods: A comprehensive review of the literature was conducted (using PubMed) to evaluate the hallmark symptoms seen after spaceflight and SCI. This literature was then examined critically to determine symptoms common to both populations. Results: Both SCI and prolonged microgravity exposure are associated with marked deteriorations in various physiological functions. Atrophy in muscle and bone, cardiovascular disturbances, and alterations in renal, immune and sensory motor systems are conditions commonly observed not only in individuals with SCI, but also in those who experience prolonged gravity unloading. Conclusion: The preponderance of data indicates that similar physiological changes occur in both SCI and prolonged space flight. These findings have important implications for future research in SCI and prolonged space flight.

show abstract

Blood Volume and Hemoglobin After Spinal Cord Injury

Abstract: These results suggest that total blood volume and hemoglobin mass are decreased in spinal cord-injured individuals with a lesion above T4, which may be related to their inactive lifestyle, because total blood volume increased with increased physical activity in these subjects.

Cited by 45 publications

References 21 publications

Salt wasting, hypotension, polydipsia, and hyponatremia and the level of spinal cord injury

Salt wasting, hypotension, polydipsia, and hyponatremia and the level of spinal cord injury

Peripheral vascular function in spinal cord injury: a systematic review

Challenges, concerns and common problems: physiological consequences of spinal cord injury and microgravity

Contact Info

Product

Resources

About