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Clinical Practice Guideline Development for Autonomic Dysreflexia in Spinal Cord Injury Publisher



Ebrahimi H1, 2 ; Maroufi SF1 ; Abdollahzadegan S1 ; Rahimimovaghar V1, 2, 3, 4, 5, 6
Authors
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Authors Affiliations
  1. 1. Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran
  2. 2. Brain and Spinal Cord Injury Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
  3. 3. Department of Neurosurgery, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
  4. 4. Universal Scientific Education and Research Network (USERN), Tehran, Iran
  5. 5. Institute of Biochemistry and Biophysics, University of Tehran, Tehran, Iran
  6. 6. Spine Program, University of Toronto, Toronto, Canada

Source: Medical Journal of the Islamic Republic of Iran Published:2023


Abstract

Background: Autonomic Dysreflexia (AD) is a crucial emergency complication of cervical and upper thoracic spinal cord injury (SCI). Although there are several treatment options for AD, unfortunately, there is no consensus on the treatment of AD. This study aimed to present Clinical Practice Guidelines (CPG) development for AD in SCI in different conditions. Methods: The project was carried out by an executive team of general practitioners and neurosurgeons. A national multidisciplinary panel of experts performed the decision-making step, which consisted of deciding on the final list of recommendations and articulating novel recommendations regarding the infrastructure and fundamental elements necessary for managing patients suffering from AD. Four appraisers evaluated the guidelines using the Appraisal of Guidelines for Research and Evaluation (AGREE II) tools. Results: A total of 575 articles were found after searching different databases. After the primary screening, title, abstract, and fulltext screening were performed, which yielded 9 records. Five were excluded after the AGREE II evaluation. The source guidelines’ recommendations were tabulated as possible scenarios for 15 patient/population, intervention, comparison, and outcomes clinical questions. Based on the expert panel’s opinion, all the recommendations were adaptable. Finally, the suggestions were transformed into a protocol for managing patients suffering from autonomic dysreflexia. Conclusion: This guideline presented the treatment and pharmacotherapy of autonomic dysreflexia. However, the treatment is being updated. We suggest more educational multimedia for health care professionals, primarily in the emergency department. © 2023 Iran University of Medical Sciences. All Rights Reserved.
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Vafa Rahimi-Movaghar (4)
Zahra Azadmanjir (2)