High or low blood pressure in patients undergoing surgery to repair a spinal cord injury may contribute to poorer outcomes and maintaining an optimal blood pressure range during surgery may help patients recover motor function. These are the key findings of a recent study published in the journal, eLife, by Abel Torres-Espin (Weill Institute for Neurosciences, San Francisco, USA), et al.
Current guidelines for treating patients with spinal cord injuries recommend avoiding low blood pressure, ensuring the adequate flow of blood to the injury site to allow recovery. But blood pressure that is too high can cause bleeding in the spinal cord that can add to the damage, note the researchers.
“The precise window for optimal blood pressure management to promote recovery from acute spinal cord injury is poorly understood”, commented Torres-Espin. “We set out to apply machine learning analytics to blood pressure and heart rate changes in operating rooms. The idea was to test the associations between these factors during surgery and neurorecovery to determine treatment thresholds that forecast recovery.”
Torres-Espin and the interdisciplinary research team analysed blood pressure data from 118 patients who underwent surgery for spinal cord injuries at the Zuckerberg San Francisco General Hospital (San Francisco, USA) and the Santa Clara Valley Medical Centre (San Jose, USA).
“We found that patients with blood pressure that was either too high or too low during surgery for an acute spinal cord injury had poorer neuromotor recovery after surgery,” said co-first author Jenny Haefeli (Weill Institute for Neurosciences, San Francisco, USA). The research team also found that patients had the best chance at recovery if their mean blood pressure was maintained between 76 mmHg and 104–117 mmHg.
The results indicate that more precise upper and lower blood pressure targets may help physicians maximise their patients’ odds of recovering after a spinal cord injury. The researchers add that if the findings are backed up by other studies, it could lead to a greater use of machine learning tools to guide the care of these patients.
“Machine learning tools could be used to create real-time models that help predict the likelihood of a patient’s recovery. Such models could also be applied to forecasting patient outcomes early after a spinal cord injury”, concludes Adam Ferguson (Weill Institute for Neurosciences, San Francisco, USA).