New Study Finds Blood Pressure Elevation Post-Spinal Cord Injury Does Not Enhance Recovery

Spinal cord injuries are a major cause of long-term disability around the globe, often affecting young individuals with lifelong neurological and physical challenges. Traditionally, medical protocols have advocated for raising blood pressure beyond normal levels in the critical initial days following such injuries, with the aim of improving blood flow to the spinal cord and promoting recovery. However, recent research challenges this approach.

A large-scale study led by Duke Health researchers examined the effects of blood pressure management on recovery outcomes. The study compared standard blood pressure treatment with an augmented approach, where blood pressure was intentionally elevated for up to a week in the intensive care unit. The findings revealed that increasing blood pressure beyond normal levels did not lead to better neurological recovery after six months. Moreover, patients in the augmented group faced higher risks of respiratory complications, longer durations of mechanical ventilation, and increased organ stress.

The research, presented at the Neurocritical Care Society Annual Meeting in Montreal and published in JAMA Network Open, raises important questions about current treatment practices. Dr. Miriam Treggiari, senior author and professor at Duke University School of Medicine, stated that the findings suggest clinicians should reconsider the routine use of blood pressure augmentation, especially considering the added health risks and healthcare costs involved.

In the study, 92 adults with acute spinal cord injuries across various trauma centers were randomized to receive either standard or augmented blood pressure management. Evaluations six months later assessed not only neurological function but also quality of life and related health complications. The ultimate conclusion was that elevating blood pressure does not improve motor or sensory recovery and may pose unnecessary health risks.

These insights could lead to a reevaluation of ICU protocols related to spinal cord injury management, advocating for a more conservative approach that minimizes invasive procedures and complications while supporting patient recovery. As Dr. Treggiari emphasizes, many patients have the potential for functional improvement, underscoring the importance of tailored treatment strategies based on emerging evidence.