Article

The aims of the study were to observe cardiovascular responses during
video urodynamic studies and to identify correlations between autonomic
dysreflexia events and video urodynamic study findings in spinal cord injuries.
DESIGN: Thirty-four persons with spinal cord injury were enrolled and
investigated using continuous cardiovascular monitoring during video urodynamic
studies. Associations between cardiovascular responses and video study variables
were analyzed. RESULTS: Bladder type-specific cardiovascular responses occurred
during the study. The incidence of overactive detrusor during urodynamic study
and bladder trabeculation on voiding cystourethrogram was significantly higher in
autonomic dysreflexia persons with spinal cord injury (P < 0.05). Systolic blood
pressure changes showed moderate negative correlation (r = -0.402, P = 0.020)
with bladder compliance and high positive correlation (r = 0.810, P = 0.000) with
maximum detrusor pressure. However, no significant differences in neurological
level of injury, injury completeness, autonomic dysreflexia symptoms, and voiding
type were found. Spinal cord injury increase at each section was significantly
higher in overactive detrusor group (P < 0.05). Significant bradycardia or
tachycardia correlating with autonomic dysreflexia during urodynamic studies was
not observed. CONCLUSIONS: Unpredictable cardiovascular reactions during
urodynamic study should be considered carefully in persons with a spinal cord
injury above T6. TO CLAIM CME CREDITS: Complete the self-assessment activity and
evaluation online at http://www.physiatry.org/JournalCME CME OBJECTIVES: Upon
completion of this article, the reader should be able to: (1) Describe
limitations of previous cardiovascular monitoring during urodynamic study to
observe changes in cardiovascular responses; (2) Identify factors contributing to
autonomic dysreflexia during urodynamic testing; and (3) Discuss the effect of
morphologic features in voiding cystourethrogram including trabeculation and
vesicourethral reflux on autonomic dysreflexia. LEVEL: Advanced ACCREDITATION:
The Association of Academic Physiatrists is accredited by the Accreditation
Council for Continuing Medical Education to provide continuing medical education
for physicians.The Association of Academic Physiatrists designates this
Journal-based CME activity for a maximum of 0.5 AMA PRA Category 1 Credit(s).
Physicians should only claim credit commensurate with the extent of their
participation in the activity.

Langue : ANGLAIS