This week we profile a recent publication in Neurology from the laboratories of Dr. Brian Kwok (front row, middle) and Dr. Chris West (below) at the University of British Columbia.
Can you provide a brief overview of your lab’s current research focus?
Our lab is focused on improving the management and outcomes of patients with acute spinal cord injuries (SCI). To this end, we are actively engaged in establishing biomarkers of injury severity to help stratify the severity of injury and better prognosticate outcome. Additionally, we are working to understand the biology of acute human SCI through the proteomic, metabolomic, lipidomic, and genomic study of human blood and cerebrospinal fluid (CSF) from acutely injured patients. In the laboratory we seek to understand the physiologic responses to cord injury and how this can be managed optimally with basic hemodynamic management strategies. In our collaboration with Dr. Chris West (co-author), we are trying to understand how the heart is affected by acute SCI, and optimize cardiac function in the early post-injury setting.
What is the significance of the findings in this publication?
In this study we inserted lumbar drains in patients with acute SCI, and evaluated how monitoring of the cerebrospinal fluid (CSF) pressure around the spinal cord could assist in optimizing the hemodynamic management of these patients. By showing that the monitoring of CSF pressure (and subsequent calculation of spinal cord perfusion pressure) was a better predictor of neurologic improvement than our standard monitoring of blood pressure, we demonstrate that this relatively simple monitoring technique (lumbar drain placement) may improve the management and outcome of acute SCI patients.
What are the next steps for this research?
We need to next validate these promising findings in an independent sample of patients in which we will actively manage the spinal cord perfusion pressure instead of just the blood pressure, to show that monitoring pressure with the lumbar drains is a valuable technique for acute SCI patients.
This research was funded by:
This work was funded by the Rick Hansen Institute, and also by the Michael Smith Foundation for Health Research and Vancouver Coastal Health Research Institute.
