Clinical trial - spinal cord injury & steroids
Basics
- early decompression and stabilization when indicated (within 24 hours)
- MAP goal from 75-80 to 90-95 for 3-7 days after injury
- steroids are controversial
> methylprednisolone 5.4 mg/Kg/h initiated within 8 hours of injury and continued for a 24h infusion may be beneficial
Is steroids effective?
Trials
NASCIS I (1984)
- no significant difference
NASCIS II (1990)
- no significant difference
NASCIS III (1997)
- no significant difference
Cochrane reviews (2012 & 2016)
- motor function improvement
AANS/CNS guidelines
- do not recommend steroids for spinal cord injury
- not approved by FDA
