Neuroanesthesia & neurocritical care
Early Blood Pressure Targets in Acute Spinal Cord Injury: A Randomized Clinical Trial
Authors' conclusion
Although underpowered, this randomized clinical trial of patients with spinal cord injury did not demonstrate better neurologic recovery comparing early augmented and conventional blood pressure and calls this practice into question.
Study context
- Population
- Adults (≥18 years) with acute spinal cord injury at 13 large US trauma centers38 completed follow-up
- Participants
- 92 adults
- Comparison
- Augmented vs conventional MAP for 7 days or until ICU discharge
- Primary endpoint
- Change in motor and sensory American Spinal Injury Association Impairment Scale scores from baseline
- Follow-up
- 6 months
Methodological detailsmulticentre
- Multicentre
Primary result
As reported in the abstract
Change from baseline in ASIA scores among survivors
Augmented
34.95
mean · SD 3.25
Conventional
32.95
mean · SD 3.65
Augmented
18.53
mean · SD 4.62
Conventional
19.95
mean · SD 4.59
Augmented
108.47
mean · SD 12.49
Conventional
130.89
mean · SD 14.87
Augmented vs ConventionalDifference (95% CI)P value
Upper extremity motor score
2.48(−5.93 to 10.90)
P = 0.55Lower extremity motor score
−4.56(−16.11 to 7.03)
P = 0.43Total sensory score
−32.00(−65.40 to 1.40)
P = 0.06Secondary outcomes
Mortality and other secondary outcomes
- No differences observed
Safety
| Outcome | Augmented | Conventional | Estimate | P value | |
|---|---|---|---|---|---|
| Modified SOFA score (excluding cardiovascular components) · day 3Mean | 1.65 (SD 1.79) | 0.80 (SD 1.10) | difference 0.85 (95% CI 0.23–1.47) | P = 0.008 | |
| Modified SOFA score (excluding cardiovascular components) · day 6Mean | 1.55 (SD 1.82) | 0.80 (SD 1.35) | difference 0.74 (95% CI 0.05–1.44) | P = 0.04 | |
| Respiratory complications | 78% | 39% | risk difference 40% (95% CI 22%–58%) | P < 0.001 | |
| −50050100Difference (linear scale) |
Mean, days
| Outcome | Augmented | Conventional | Difference (days) (95% CI) | P value | |
|---|---|---|---|---|---|
| Mechanical ventilatory support | 9.44 (SD 15.27) | 3.78 (SD 8.42) | 5.67 (0.48–10.85) | P = 0.03 | |
| −5051015Difference, days (linear scale) |
Original publication
Early Blood Pressure Targets in Acute Spinal Cord Injury: A Randomized Clinical Trial. JAMA Netw Open. Published 2 September 2025. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →