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 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.


METHODS
Veterans Administration health care system.


METHODS
Veterans Health Administration National SCI Staff Physicians were sent an electronic email to participate in the anonymous web-based survey.


METHODS
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.


CONCLUSIONS
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.
Department of Physical Medicine and Rehabilitation, Virginia Commonwealth University, Richmond, USA. carusomd@gmail.com.|Department of Veterans Affairs, Hunter Holmes McGuire Medical Center, 1201 Broad Rock Boulevard, Richmond, VA, 23249, USA. carusomd@gmail.com.
Deborah
D
Caruso
Department of Physical Medicine and Rehabilitation, Virginia Commonwealth University, Richmond, USA.|Department of Veterans Affairs, Hunter Holmes McGuire Medical Center, 1201 Broad Rock Boulevard, Richmond, VA, 23249, USA.
David
D
Gater
Department of Physical Medicine and Rehabilitation, Virginia Commonwealth University, Richmond, USA.|Department of Veterans Affairs, Hunter Holmes McGuire Medical Center, 1201 Broad Rock Boulevard, Richmond, VA, 23249, USA.
Christopher
C
Harnish
D020211:Autonomic Dysreflexia / Q000175:diagnosis* / Q000453:epidemiology / Q000517:prevention & control*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010820:Physicians / Q000639:trends; D017410:Practice Guidelines as Topic / Q000592:standards*; D011446:Prospective Studies; D013119:Spinal Cord Injuries / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy; D011795:Surveys and Questionnaires
Autonomic dysreflexia; Paraplegia; Quadriplegia; Spinal cord injuries