Treatment of Spinal Cord Ischemia with Cell Impermeant-Based Resuscitation

Abstract

Spinal Cord Injury (SCI) is a serious problem for warfighters injured in far forward areas. Progressive spinal cord tissue swelling secondary to closed trauma aggravate the initial injury. A new low volume resuscitation (LVR) platform using cell impermeant polymers protects systemic tissues after trauma and ischemia by reversing and preventing lethal cell and tissue metabolic swelling. This improves microcirculation and oxygen delivery early after injury. The aim of this project was to test this strategy in SCI in rodents. First, polyethylene glycol (PEG) polymers were sized to optimize use in the spinal cord since the capillary permeability is different. A cocktail of PEG-2k, -5k, and -20k was developed and used in rodent SCI studies. The crystalloid used after injury suppressed tissue swelling and inflammation but failed to affect motor outcomes over 60 days after injury. Return of function of neurogenic bladder was accelerated. Additional dosing, which was deemed needed, produced a study limiting gastroparesis not seen in swine. Although this study was negative, we believe additional doses would produce better outcomes and has potential use in humans.

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Document Details

Document Type
Technical Report
Publication Date
Dec 01, 2021
Accession Number
AD1209093

Entities

People

  • Martin J Mangino

Organizations

  • Virginia Commonwealth University

Tags

Communities of Interest

  • Biomedical

DTIC Thesaurus Topics

  • Animal Structures
  • Biomedical Research
  • Blood
  • Blood Volume
  • Cardiovascular Physiological Phenomena
  • Cardiovascular System
  • Cells
  • Cellular Structures
  • Digestive System Processes
  • Drinking Water
  • Forward Areas
  • Gastrointestinal Diseases
  • Health Services
  • Hemorrhagic Shock
  • Maryland
  • Medical Personnel
  • Molecules
  • Polymers
  • Spinal Cord
  • Spinal Injuries
  • Spine
  • Surgery
  • Technicians
  • Tissues
  • Universities

Fields of Study

  • Medicine

Readers

  • Cardiovascular Physiology
  • Neuroscience
  • Trauma Surgery or Emergency Medicine.