Prevention of recurrent autonomic dysreflexia: a survey of current practice

Objective There is a dearth of literature on the treatment of chronic recurrent autonomic dysreflexia (AD), a well-known complication of spinal cord injury that can have life-threatening implications. This study sought to identify clinical practices regarding the treatment of AD, both acute and recu...

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Bibliographic Details
Published in:Clinical autonomic research 2015-10, Vol.25 (5), p.293-300
Main Authors: Caruso, Deborah, Gater, David, Harnish, Christopher
Format: Article
Language:English
Subjects:
Autonomic Dysreflexia - diagnosis
Autonomic Dysreflexia - epidemiology
Autonomic Dysreflexia - prevention & control
Cardiology
Diabetes
Endocrinology
Female
Gastroenterology
Humans
Male
Medicine
Medicine & Public Health
Middle Aged
Neurology
Ophthalmology
Physicians - trends
Practice Guidelines as Topic - standards
Prospective Studies
Research Article
Spinal Cord Injuries - diagnosis
Spinal Cord Injuries - epidemiology
Spinal Cord Injuries - therapy
Surveys and Questionnaires
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Summary:Objective There is a dearth of literature on the treatment of chronic recurrent autonomic dysreflexia (AD), a well-known complication of spinal cord injury that can have life-threatening implications. This study sought to identify clinical practices regarding the treatment of AD, both acute and recurrent, in patients with spinal cord injury (SCI). Methods Online survey regarding AD management in SCI composed of 11 questions designed to obtain information on respondent characteristics, AD treatment options, and causes of AD. Setting Veterans Administration health care system. Participants Veterans Health Administration National SCI Staff Physicians were sent an electronic email to participate in the anonymous web-based survey. Intervention None applicable. Results The response rate was 52 %. The most commonly prescribed medications for minor and severe acute manifestations of AD were nitrates. For recurrent AD, clonidine was the most commonly prescribed medication. Interpretation Anti-hypertensive medications continue to be the mainstay in the management of both acute and chronic recurrent AD. Current literature is lacking in prospective randomized controlled trials investigating the relative efficacy of AD interventions. Evidence-based practice guidelines are necessary to improve clinical care.
ISSN:0959-9851
1619-1560
DOI:10.1007/s10286-015-0303-0